Provider Demographics
NPI:1265417547
Name:SPADO, MARLENE ANDREA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARLENE
Middle Name:ANDREA
Last Name:SPADO
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 1:7827 SW 102ND PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3903
Mailing Address - Country:US
Mailing Address - Phone:305-274-2528
Mailing Address - Fax:305-412-2404
Practice Address - Street 1:7827 SW 102ND PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3903
Practice Address - Country:US
Practice Address - Phone:305-310-0971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-09
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00009181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ9984OtherBCBS