Provider Demographics
NPI:1053559484
Name:HOLGUIN, LUZ STELLA (LMSW)
Entity type:Individual
Prefix:MS
First Name:LUZ
Middle Name:STELLA
Last Name:HOLGUIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 SELWYN AVE APT 7D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7688
Mailing Address - Country:US
Mailing Address - Phone:718-960-1383
Mailing Address - Fax:718-960-1039
Practice Address - Street 1:1650 SELWYN AVE APT 7D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7688
Practice Address - Country:US
Practice Address - Phone:718-960-1383
Practice Address - Fax:718-960-1039
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72 073258104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker