Provider Demographics
NPI:1801985866
Name:GOLONDRINO, BIANCA E (LCSW)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:E
Last Name:GOLONDRINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BIANCA
Other - Middle Name:
Other - Last Name:DE ANDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:12330 FAIRLAWN DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-3906
Mailing Address - Country:US
Mailing Address - Phone:310-463-8115
Mailing Address - Fax:
Practice Address - Street 1:12330 FAIRLAWN DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-3906
Practice Address - Country:US
Practice Address - Phone:310-463-8115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80366101YM0800X, 101YP2500X, 104100000X, 261QM0801X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)