Provider Demographics
NPI:1295274736
Name:SOTOLONGO, NIURKA (LMHC)
Entity type:Individual
Prefix:MS
First Name:NIURKA
Middle Name:
Last Name:SOTOLONGO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15715 S DIXIE HWY STE 205
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1875
Mailing Address - Country:US
Mailing Address - Phone:954-624-6016
Mailing Address - Fax:
Practice Address - Street 1:15715 S DIXIE HWY STE 205
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-1875
Practice Address - Country:US
Practice Address - Phone:954-624-6016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-16
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14266101YM0800X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst