MEDICARE: ELIZABETH VAH 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
1	1041C0700X	Clinical Social Worker	SW10407	FL
2	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265786404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH VAH LCSW

Provider Business Mailing Address
First Line	:	1400 E OAKLAND PARK BLVD STE 210
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33334-4400
Country	:	US
Telephone Number	:	954-561-6222
Fax Number	:	954-990-7650

Provider Business Practice Location Address
First Line	:	5901 SW 74TH ST STE 408
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5164
Country	:	US
Telephone Number	:	305-735-3555
Fax Number	:	954-990-7650

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2012
Last Update Date	:	06/23/2022

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