1639444094 NPI number — DIANA GONZALEZ-JOYA, LCSW

Table of content: (NPI 1639444094)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639444094 NPI number — DIANA GONZALEZ-JOYA, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIANA GONZALEZ-JOYA, LCSW
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639444094
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5841 SW 51ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33155-6319
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-229-6074
Provider Business Mailing Address Fax Number:
305-266-2147

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6601 SW 80TH ST
Provider Second Line Business Practice Location Address:
STE 202
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33143-4661
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-229-6074
Provider Business Practice Location Address Fax Number:
305-266-2147
Provider Enumeration Date:
03/19/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GONZALEZ-JOYA
Authorized Official First Name:
DIANA
Authorized Official Middle Name:
Authorized Official Title or Position:
LICENSED CLINICAL SOCIAL WORKER
Authorized Official Telephone Number:
786-229-6074

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)