MEDICARE: MARGARET MARY PASSERI LISW, 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	101YM0800X	Mental Health Counselor	00292	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SW10169	OTHER	FL	SECOND LICENSE

General Provider Information

NPI Number	:	1558349829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET MARY PASSERI LISW, LCSW

Provider Business Mailing Address
First Line	:	1294 13TH ST N
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34102-5238
Country	:	US
Telephone Number	:	239-692-9422
Fax Number	:

Provider Business Practice Location Address
First Line	:	1415 PANTHER LN STE 223
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-7874
Country	:	US
Telephone Number	:	239-571-0435
Fax Number	:

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

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	10/31/2012

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