Provider Demographics
NPI:1730102880
Name:NELSON-PATNAUDE, ALANA (LCSW)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:NELSON-PATNAUDE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4987 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 2409
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-4506
Mailing Address - Country:US
Mailing Address - Phone:954-592-4886
Mailing Address - Fax:
Practice Address - Street 1:4987 N UNIVERSITY DR
Practice Address - Street 2:SUITE 2409
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-4506
Practice Address - Country:US
Practice Address - Phone:954-592-4886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW36331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ6297Medicare ID - Type UnspecifiedPROVIDER NUMBER