MEDICARE: MRS. CAROL SASSOON 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	SW0002969	FL

General Provider Information

NPI Number	:	1669648150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROL SASSOON LCSW

Provider Business Mailing Address
First Line	:	3900 N HILLS DR
Second Line	:	SUITE 214
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021
Country	:	US
Telephone Number	:	954-701-5526
Fax Number	:	754-323-4234

Provider Business Practice Location Address
First Line	:	3900 N HILLS DR APT 214
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2554
Country	:	US
Telephone Number	:	954-701-5526
Fax Number	:	754-323-4234

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

Provider Enumeration Date	:	05/05/2008
Last Update Date	:	05/05/2008

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