is a Clinical in Fort Myers, Florida. practices all healthcare services and medical treatments related to Clinical. The NPI Number for is 1982861076. The last update date is .
's current location address is 3960 Ellis Rd, Fort Myers, Florida. You can contact this provider via phone number 2398511838. The mailing address for is 3960 Ellis Rd, Fort Myers, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 3960 Ellis Rd, Fort Myers, Florida |
| Phone Number | 2398511838 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1982861076 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 3960 Ellis Rd |
|---|---|
| City | Fort Myers |
| State | Florida (FL) |
| Post Code | 339056400 |
| Phone Number | 2398511838 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | SW5653 |
|
Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| Z9956 | FL | BLUE CROSS/BLUE SHIELD |
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