MEDICARE: PRISCILLA O DAY 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	SW558	FL
2	1041C0700X	Clinical Social Worker	SW0558	FL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831177914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA O DAY LCSW

Provider Business Mailing Address
First Line	:	4831 N. E. 26TH AVENUE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4816
Country	:	US
Telephone Number	:	954-776-7992
Fax Number	:	954-776-6850

Provider Business Practice Location Address
First Line	:	6245 NORTH FEDERAL HIGHWAY
Second Line	:	SUITE 423
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-1998
Country	:	US
Telephone Number	:	954-776-7992
Fax Number	:	954-776-6850

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

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	09/21/2022

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Directions to “ PRISCILLA O DAY LCSW” Practice Location

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