Individual provider · NPI-1

Liesl Marie Botelho, LCSW

Social Worker, Clinical · Ocala, FL

NPI number1639490972
StatusActive
Last updated in NPPESSep 13, 2026

Details

NPI
1639490972
Entity type
Individual (NPI-1)
Name
Liesl Marie Botelho
Credential
LCSW
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 22, 2010
Certification date
Sep 13, 2026
Last updated
Sep 13, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, ClinicalSW26234FLYes

Practice location

4420 Se 53rd Ave
Ocala, FL 34480-7403

Phone 781-521-8202

Mailing address

4420 Se 53rd Ave
Ocala, FL 34480-7403

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