Provider Demographics
NPI:1659617413
Name:PRADELLA, MIROSLAVA LINETT (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:MIROSLAVA
Middle Name:LINETT
Last Name:PRADELLA
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1245 HEWLETT PLZ UNIT 133
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-4006
Mailing Address - Country:US
Mailing Address - Phone:516-415-1100
Mailing Address - Fax:
Practice Address - Street 1:224 FRANKLIN AVE STE 10
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1928
Practice Address - Country:US
Practice Address - Phone:516-721-7500
Practice Address - Fax:516-421-7501
Is Sole Proprietor?:No
Enumeration Date:2012-12-26
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0845951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical