Provider Demographics
NPI:1285498618
Name:ESCALANTE, SIMONE MICHELLE (LCSW)
Entity type:Individual
Prefix:
First Name:SIMONE
Middle Name:MICHELLE
Last Name:ESCALANTE
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 1:2250 NW 83RD AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3531
Mailing Address - Country:US
Mailing Address - Phone:305-206-9997
Mailing Address - Fax:
Practice Address - Street 1:2250 NW 83RD AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3531
Practice Address - Country:US
Practice Address - Phone:305-206-9997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW145491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical