Provider Demographics
NPI:1376838177
Name:ESRAELIAN, FLORA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:FLORA
Middle Name:
Last Name:ESRAELIAN
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 1:5150 N 6TH ST
Mailing Address - Street 2:#116
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7510
Mailing Address - Country:US
Mailing Address - Phone:559-355-9966
Mailing Address - Fax:
Practice Address - Street 1:5150 N 6TH ST
Practice Address - Street 2:#116
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7510
Practice Address - Country:US
Practice Address - Phone:559-355-9966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24676101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health