MEDICARE: SONIA MILENA SHUHART 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	0904008767	VA
2	1041C0700X	Clinical Social Worker	S17114	FL

General Provider Information

NPI Number	:	1871990085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA MILENA SHUHART LCSW

Provider Business Mailing Address
First Line	:	2100 WASHINGTON BLVD
Second Line	:	FLOOR 4
City	:	ARLINGTON
State	:	VA
Zip	:	22204-5703
Country	:	US
Telephone Number	:	703-228-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 B 6TH AVE E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34208-3420
Country	:	US
Telephone Number	:	941-243-1252
Fax Number	:

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

Provider Enumeration Date	:	12/03/2014
Last Update Date	:	03/23/2023

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