Provider Demographics
NPI:1386423077
Name:OCHOA, HUSTON (LCSW)
Entity type:Individual
Prefix:
First Name:HUSTON
Middle Name:
Last Name:OCHOA
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 1:3160 POWERLINE RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-5911
Mailing Address - Country:US
Mailing Address - Phone:305-773-7844
Mailing Address - Fax:
Practice Address - Street 1:3160 POWERLINE RD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-5911
Practice Address - Country:US
Practice Address - Phone:305-773-7844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW220221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical