Provider Demographics
NPI:1063715654
Name:GOMEZ-CASSERES, LUZ ESTELA (LCSW)
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:ESTELA
Last Name:GOMEZ-CASSERES
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 1:6019 MILESTONE DR
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-2611
Mailing Address - Country:US
Mailing Address - Phone:484-550-0382
Mailing Address - Fax:
Practice Address - Street 1:5357 EHRLICH RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-5505
Practice Address - Country:US
Practice Address - Phone:855-417-2486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-21
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0165221041C0700X
NV9207-C1041C0700X
FLSW202611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical