Healthcare Provider Details

I. General information

NPI: 1093694663
Provider Name (Legal Business Name): DANA MARCONE DEDONATO MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 CORKSCREW RD STE 12
ESTERO FL
33928-3216
US

IV. Provider business mailing address

17215 ASHCOMB WAY
ESTERO FL
33928-6474
US

V. Phone/Fax

Practice location:
  • Phone: 239-799-6952
  • Fax: 239-366-4006
Mailing address:
  • Phone: 609-457-7971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW14527
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: