Provider Demographics
NPI:1154870541
Name:MORAN, NATHALI ROCIO (MCSW, RCSWI)
Entity type:Individual
Prefix:
First Name:NATHALI
Middle Name:ROCIO
Last Name:MORAN
Suffix:
Gender:F
Credentials:MCSW, RCSWI
Other - Prefix:
Other - First Name:NATHALI
Other - Middle Name:ROCIO
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MCSW
Mailing Address - Street 1:1244 MARTIN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-6133
Mailing Address - Country:US
Mailing Address - Phone:407-276-3502
Mailing Address - Fax:
Practice Address - Street 1:1002 N SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3531
Practice Address - Country:US
Practice Address - Phone:407-275-8939
Practice Address - Fax:407-282-3674
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health