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Individual
DR. MARITZA FERNANDEZ
Active
Individual
DR. MARITZA FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-R, CASAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19671
NY
1041C0700X
Clinical Social Worker
Primary
078470
NY
1041C0700X
Clinical Social Worker
10308
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04029058
—
NY
01
—
078470
LICENSE
NY
01
—
10308
LICENSE
FL
01
—
19671
CREDENTIAL
NY
01
—
3233
CREDENTIAL
FL
01
—
A400111965
MEDICARE PTAN
NY
Enumeration date
07/08/2010
Last updated
05/11/2023
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