Van Baalen, Stacia Ann
Van Baalen, Stacia Ann is an sole proprietor health care provider with primary practice located at 19001 Sw 106Th Ave # C-103 , Cutler Bay FL 33157-7669. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Van Baalen, Stacia Ann can be contacted via phone (786) 227-5000.Contact Information
Primary practice address
19001 Sw 106Th Ave # C-103
Cutler Bay FL 33157-7669
Phone: (786) 227-5000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW5993 | Florida |
Profile Details
| NPI number | 1841750197 |
|---|---|
| LBN Legal business name | Van Baalen, Stacia Ann |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 22nd, 2019 |
| Last updated | Mar 22nd, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841750197 | NPPES |
| Florida | MEDICAID | 1021AB |
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