Provider Demographics
NPI:1184267775
Name:JUNEIDI, CARMEN FARAH (LCSW)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:FARAH
Last Name:JUNEIDI
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 1:68 SE 6TH ST APT 3103
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3495
Mailing Address - Country:US
Mailing Address - Phone:312-767-4224
Mailing Address - Fax:
Practice Address - Street 1:68 SE 6TH ST APT 3103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-3495
Practice Address - Country:US
Practice Address - Phone:312-767-4224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-25
Last Update Date:2024-10-16
Deactivation Date:2019-10-29
Deactivation Code:
Reactivation Date:2019-11-27
Provider Licenses
StateLicense IDTaxonomies
IL149.0215081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical