Provider Demographics
NPI:1184933814
Name:SOCHACZEWSKI, ISAAC (LMHC)
Entity type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:
Last Name:SOCHACZEWSKI
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 NE 177TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33162-2101
Mailing Address - Country:US
Mailing Address - Phone:305-505-4284
Mailing Address - Fax:
Practice Address - Street 1:17071 W DIXIE HWY
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33160-3773
Practice Address - Country:US
Practice Address - Phone:305-505-4284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 10318101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health