Healthcare Provider Details

I. General information

NPI: 1295987972
Provider Name (Legal Business Name): JENNIFER LEE CALAME LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2008
Last Update Date: 10/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8125 LAUREL HILL DR
ORLANDO FL
32818-5227
US

IV. Provider business mailing address

1718 E MICHIGAN ST
ORLANDO FL
32806-4935
US

V. Phone/Fax

Practice location:
  • Phone: 407-296-5150
  • Fax: 407-296-5152
Mailing address:
  • Phone: 407-836-8985
  • Fax: 407-836-7659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW8771
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: