Provider Demographics
NPI:1881323582
Name:PETIT-CLAIR, EDER (LCSW)
Entity type:Individual
Prefix:MR
First Name:EDER
Middle Name:
Last Name:PETIT-CLAIR
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:PO BOX 600202
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-0202
Mailing Address - Country:US
Mailing Address - Phone:786-277-7793
Mailing Address - Fax:
Practice Address - Street 1:2025 NE 164TH ST APT 1009
Practice Address - Street 2:
Practice Address - City:N MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4162
Practice Address - Country:US
Practice Address - Phone:786-277-7793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL194301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical