Provider Demographics
NPI:1710315684
Name:MIGLIONICO, ANN-MARIE D (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANN-MARIE
Middle Name:D
Last Name:MIGLIONICO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:ANN-MARIE
Other - Middle Name:
Other - Last Name:RAMDHANIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:12617 NARCOOSSEE ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832
Mailing Address - Country:US
Mailing Address - Phone:407-738-9408
Mailing Address - Fax:949-543-2325
Practice Address - Street 1:12617 NARCOOSSEE ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832
Practice Address - Country:US
Practice Address - Phone:407-738-9408
Practice Address - Fax:949-543-2325
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-31
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW132711041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016598100Medicaid