Healthcare Provider Details

I. General information

NPI: 1033841002
Provider Name (Legal Business Name): RENEE DELGADO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 06/28/2022
Certification Date: 06/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8371 DIVER LN
SPRING HILL FL
34608-6015
US

IV. Provider business mailing address

8371 DIVER LN
SPRING HILL FL
34608-6015
US

V. Phone/Fax

Practice location:
  • Phone: 352-403-7394
  • Fax:
Mailing address:
  • Phone: 352-403-7394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW017384
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: