MEDICARE: JEFFREY SHEARER 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	0904015286	VA
2	1041C0700X	Clinical Social Worker	SW3824	FL

General Provider Information

NPI Number	:	1942341276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY SHEARER LCSW

Provider Business Mailing Address
First Line	:	2609 NE 14TH AVE APT 110
Second Line	:
City	:	WILTON MANORS
State	:	FL
Zip	:	33334-4388
Country	:	US
Telephone Number	:	954-830-7660
Fax Number	:	954-302-4961

Provider Business Practice Location Address
First Line	:	2609 NE 14TH AVE APT 110
Second Line	:
City	:	WILTON MANORS
State	:	FL
Zip	:	33334-4388
Country	:	US
Telephone Number	:	954-830-7660
Fax Number	:	954-302-4961

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

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	05/14/2024

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Directions to “ JEFFREY SHEARER LCSW” Practice Location

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