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NPI 1215106505

NPI 1215106505 : LORI PINK, LCSW, PA : PLANTATION, FL

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General NPI Number Information
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    NPI Number           |    1215106505
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    Entity Type          |    Organization 
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    Legal Business Name  |    LORI PINK, LCSW, PA 
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Dates
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    Enumeration Date     |    02/21/2008
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    Last Update Date     |    10/01/2024
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Provider Practice Location Address
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    Address Line         |    950 S PINE ISLAND RD STE 150A 
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    City                 |    PLANTATION
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    State                |    FL
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    Zip                  |    33324-3918
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    Country              |    US
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    Telephone            |    954-584-6478
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    Fax                  |    954-797-4911
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Provider Business Mailing Address
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    Address Line         |    950 S PINE ISLAND RD STE 150A 
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    City                 |    PLANTATION
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    State                |    FL
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    Zip                  |    33324-3918
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    Country              |    US
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    Telephone            |    954-584-6478
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    Fax                  |    954-797-4911
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |    MS. LORI  PINK 
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    Credential           |    LCSW
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    Telephone            |    954-584-6478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    SW3818
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    License Number State |    FL
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