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NPI Code Detail

MEDICARE: MS. LEAH DENISE SANDRIDGE LCSW

MEDICARE: MS. LEAH DENISE SANDRIDGE 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 WorkerSW-004581FL

General Provider Information

NPI Number : 1588806442
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LEAH DENISE SANDRIDGE LCSW
Provider Business Mailing Address
First Line : 4371 VERONICA S SHOEMAKER BLVD
Second Line :
City : FORT MYERS
State : FL
Zip : 33916-2216
Country : US
Telephone Number : 239-274-8200
Fax Number :
Provider Business Practice Location Address
First Line : 5985 SILVER FALLS RUN STE 200
Second Line :
City : BRADENTON
State : FL
Zip : 34211-1291
Country : US
Telephone Number : 941-907-4737
Fax Number : 941-907-9493
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2009
Last Update Date : 11/19/2021

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Directions to “ MS. LEAH DENISE SANDRIDGE LCSW” Practice Location

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