Provider Demographics
NPI:1700989142
Name:FREAY LOCARNO, MARBEL (LCSW)
Entity Type:Individual
Prefix:
First Name:MARBEL
Middle Name:
Last Name:FREAY LOCARNO
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 1:1400 W OAK ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4000
Mailing Address - Country:US
Mailing Address - Phone:321-250-1054
Mailing Address - Fax:321-256-0307
Practice Address - Street 1:1400 W OAK ST
Practice Address - Street 2:SUITE G
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4000
Practice Address - Country:US
Practice Address - Phone:321-250-1054
Practice Address - Fax:321-256-0307
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2023-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLSW71841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ084QMedicare ID - Type Unspecified