Provider Demographics
NPI:1710089214
Name:HYMAN, STANLEY NEIL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:NEIL
Last Name:HYMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2999 NE 191ST ST
Mailing Address - Street 2:SUITE 703
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3123
Mailing Address - Country:US
Mailing Address - Phone:305-933-9779
Mailing Address - Fax:
Practice Address - Street 1:2999 NE 191ST ST
Practice Address - Street 2:SUITE 703
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3123
Practice Address - Country:US
Practice Address - Phone:305-933-9779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW28611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL17444472OtherUBH
FL17444472OtherUBH