Provider Demographics
NPI:1336628999
Name:CEFALU, DARREN GERARD (LCSW)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:GERARD
Last Name:CEFALU
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 EUCLID AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-8666
Mailing Address - Country:US
Mailing Address - Phone:305-528-1165
Mailing Address - Fax:
Practice Address - Street 1:635 EUCLID AVE APT 101
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-8666
Practice Address - Country:US
Practice Address - Phone:305-528-1165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW153261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW15326OtherDEPARTMENT OF HEALTH