Provider Demographics
NPI:1245048354
Name:CERRA, COSSET (ISW)
Entity type:Individual
Prefix:
First Name:COSSET
Middle Name:
Last Name:CERRA
Suffix:
Gender:F
Credentials:ISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 SUNSET DR STE 123
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3001
Mailing Address - Country:US
Mailing Address - Phone:305-302-4776
Mailing Address - Fax:305-468-6351
Practice Address - Street 1:10300 SUNSET DR STE 123
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3001
Practice Address - Country:US
Practice Address - Phone:305-302-4776
Practice Address - Fax:305-468-6351
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW189961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical