Provider Demographics
NPI:1649619552
Name:SAINT-VICTOR REMY, GAETANE (LCSW-QS)
Entity type:Individual
Prefix:
First Name:GAETANE
Middle Name:
Last Name:SAINT-VICTOR REMY
Suffix:
Gender:F
Credentials:LCSW-QS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 NW 116TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33168-4423
Mailing Address - Country:US
Mailing Address - Phone:786-369-6525
Mailing Address - Fax:
Practice Address - Street 1:130 NW 116TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-4423
Practice Address - Country:US
Practice Address - Phone:786-369-6525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
FLSW168531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker