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NPI Code Detail

MEDICARE: LEAH M PAVELA-MULLINS LCSW

MEDICARE: LEAH M PAVELA-MULLINS LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerSW7224FL

General Provider Information

NPI Number : 1013017789
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH M PAVELA-MULLINS LCSW
Provider Business Mailing Address
First Line : 2808 NE 22ND ST
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33305-2804
Country : US
Telephone Number : 954-664-9460
Fax Number : 954-564-1371
Provider Business Practice Location Address
First Line : 2808 NE 22ND ST
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33305-2804
Country : US
Telephone Number : 954-664-9460
Fax Number : 954-564-1371
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2006
Last Update Date : 10/23/2024

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Directions to “ LEAH M PAVELA-MULLINS LCSW” Practice Location

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