Provider Demographics
NPI:1891114427
Name:PRECKAJLO, NATASHA KALUBY (LCSW)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:KALUBY
Last Name:PRECKAJLO
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 1:5335 NW 87TH AVE STE C109
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2834
Mailing Address - Country:US
Mailing Address - Phone:786-551-9550
Mailing Address - Fax:
Practice Address - Street 1:10407 SYLVAN LN W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-6241
Practice Address - Country:US
Practice Address - Phone:904-502-3091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW140871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical