Provider Demographics
NPI:1861829954
Name:CARMENATE, ROXANA YASMIN (LCSW-QS, MSW)
Entity Type:Individual
Prefix:MS
First Name:ROXANA
Middle Name:YASMIN
Last Name:CARMENATE
Suffix:
Gender:F
Credentials:LCSW-QS, MSW
Other - Prefix:MRS
Other - First Name:ROXANA
Other - Middle Name:YASMIN
Other - Last Name:CARMENATE PUPO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1831 NW 104TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-2354
Mailing Address - Country:US
Mailing Address - Phone:954-200-2545
Mailing Address - Fax:
Practice Address - Street 1:9734 W SAMPLE RD # 200
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4004
Practice Address - Country:US
Practice Address - Phone:954-903-1323
Practice Address - Fax:954-431-6993
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW114381041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health