Provider Demographics
NPI:1134837313
Name:MORISSEAU, ESTHER
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:MORISSEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:
Other - Last Name:MORISSEAU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:13220 NW 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33167-1623
Mailing Address - Country:US
Mailing Address - Phone:305-439-2717
Mailing Address - Fax:
Practice Address - Street 1:13220 NW 17TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33167-1623
Practice Address - Country:US
Practice Address - Phone:305-439-2717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL591775062Medicaid