Provider Demographics
NPI:1679032973
Name:PAREDES, MAILYN C (MSW)
Entity Type:Individual
Prefix:MS
First Name:MAILYN
Middle Name:C
Last Name:PAREDES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 MILITARY TRL STE 306
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7816
Mailing Address - Country:US
Mailing Address - Phone:561-781-3333
Mailing Address - Fax:
Practice Address - Street 1:2055 MILITARY TRL STE 306
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7816
Practice Address - Country:US
Practice Address - Phone:561-781-3333
Practice Address - Fax:561-768-9161
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-16
Last Update Date:2019-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ISW4268104100000X
FLISW4268104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker