Provider Demographics
NPI:1932211711
Name:CASAL, BEATRIZ T (LCSW)
Entity type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:T
Last Name:CASAL
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 1:11440 NORTH KENDALL DRIVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1024
Mailing Address - Country:US
Mailing Address - Phone:305-279-4966
Mailing Address - Fax:305-279-4966
Practice Address - Street 1:11440 NORTH KENDALL DRIVE
Practice Address - Street 2:SUITE 106
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176
Practice Address - Country:US
Practice Address - Phone:305-279-4966
Practice Address - Fax:305-279-4966
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0001636103T00000X
FLSWFL00016361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
57538OtherUNITED BEHAVIORAL HEALTH
Z2435OtherBCBS OF FL
FLZ2435Medicare PIN