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General NPI Number Information
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NPI Number | 1285167742
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Entity Type | Individual
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Provider Name | LAURA ARMIDE JEANIS BSW, MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/11/2017
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 9050 PINES BLVD STE 305
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6422
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Country | US
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Telephone | 754-283-9665
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Fax |
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Provider Business Mailing Address
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Address Line | 13173 SW 44TH ST
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City | MIRAMAR
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State | FL
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Zip | 33027-3114
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Country | US
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Telephone | 754-280-8805
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | SW20897
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License Number State | FL
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