Provider Demographics
NPI:1821397845
Name:MALCA-CHERN, DIANA PATRICIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:PATRICIA
Last Name:MALCA-CHERN
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 1:660 NE 176TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33162-2030
Mailing Address - Country:US
Mailing Address - Phone:305-788-7738
Mailing Address - Fax:305-305-3288
Practice Address - Street 1:1380 NE MIAMI GARDENS DRIVE
Practice Address - Street 2:SUITE 271
Practice Address - City:NMB
Practice Address - State:FL
Practice Address - Zip Code:33179
Practice Address - Country:US
Practice Address - Phone:305-788-7738
Practice Address - Fax:305-328-8207
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW45571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical