Healthcare Provider Details

I. General information

NPI: 1689043234
Provider Name (Legal Business Name): ANDREW PLISNER LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2015
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 6TH ST N
SAINT PETERSBURG FL
33701-2276
US

IV. Provider business mailing address

819 6TH ST N APT 1
SAINT PETERSBURG FL
33701-2276
US

V. Phone/Fax

Practice location:
  • Phone: 914-713-5616
  • Fax:
Mailing address:
  • Phone: 313-410-8731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number092493
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: