Provider Demographics
NPI:1821430885
Name:ESCOBAR, LAURA D (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:D
Last Name:ESCOBAR
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 1:9380 SUNSET DR STE B222
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5460
Mailing Address - Country:US
Mailing Address - Phone:305-274-3172
Mailing Address - Fax:
Practice Address - Street 1:9380 SUNSET DR STE B222
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5460
Practice Address - Country:US
Practice Address - Phone:305-274-3172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 108141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical