MEDICARE: POSSIBILITIES COUNSELING SERVICES PA

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
1	1041C0700X	Clinical Social Worker	SW 6683	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z018D	OTHER	FL	BLUECROSSBLUESHIELD
2	214677	OTHER		COMPSYCH
3	294774	OTHER		AVMED

General Provider Information

NPI Number	:	1134115538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSSIBILITIES COUNSELING SERVICES PA

Provider Business Mailing Address
First Line	:	4741 NE 27TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4818
Country	:	US
Telephone Number	:	954-895-6031
Fax Number	:

Provider Business Practice Location Address
First Line	:	1975 E SUNRISE BLVD
Second Line	:	STE 513
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-1433
Country	:	US
Telephone Number	:	954-895-6031
Fax Number	:

Authorized Official
Title or Position	:	LICENSED CLINICAL SOCIAL WORKER
Name	:	MRS. SHARON DEBRA ROSEMAN
Credential	:	L.C.S.W.
Telephone Number	:	954-895-6031

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	08/22/2020

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Directions to “POSSIBILITIES COUNSELING SERVICES PA ” Practice Location

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