Provider Demographics
NPI:1962621045
Name:TAQUECHEL, ELIZABETH TAPIA (LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:TAPIA
Last Name:TAQUECHEL
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 1:10800 SW 102ND PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-3432
Mailing Address - Country:US
Mailing Address - Phone:786-573-7010
Mailing Address - Fax:
Practice Address - Street 1:14401 OLD CUTLER ROAD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33158
Practice Address - Country:US
Practice Address - Phone:786-573-7010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW53461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical