Provider Demographics
NPI:1427427475
Name:MORALES, MARIELSIE (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:MARIELSIE
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12855 SW 132ND ST STE 104
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7209
Mailing Address - Country:US
Mailing Address - Phone:786-250-3494
Mailing Address - Fax:786-250-3439
Practice Address - Street 1:12855 SW 132ND ST STE 104
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7209
Practice Address - Country:US
Practice Address - Phone:786-250-3494
Practice Address - Fax:786-250-3439
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-21
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
FL103K00000X
FLSW140681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023476600Medicaid