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NPI Code Detail

MEDICARE: JAMES MICHAEL BOGAN LCSW

MEDICARE: JAMES MICHAEL BOGAN 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 WorkerSW0001572FL

General Provider Information

NPI Number : 1215149521
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES MICHAEL BOGAN LCSW
Provider Business Mailing Address
First Line : 17011 STATE ROAD 50 STE 301
Second Line :
City : CLERMONT
State : FL
Zip : 34711-8203
Country : US
Telephone Number : 833-769-3524
Fax Number : 352-432-0106
Provider Business Practice Location Address
First Line : 17011 STATE ROAD 50 STE 301
Second Line :
City : CLERMONT
State : FL
Zip : 34711-8203
Country : US
Telephone Number : 337-693-5248
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2007
Last Update Date : 01/02/2026

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Directions to “ JAMES MICHAEL BOGAN LCSW” Practice Location

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