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General NPI Number Information
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NPI Number | 1306275185
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Entity Type | Individual
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Provider Name | ERIC SCHLEICH LCSW
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Gender | Male
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Dates
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Enumeration Date | 11/02/2013
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 710 94TH AVE N STE 305
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City | ST PETERSBURG
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State | FL
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Zip | 33702-2452
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Country | US
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Telephone | 727-642-3547
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Fax |
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Provider Business Mailing Address
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Address Line | 4697 48TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33714-2831
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Country | US
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Telephone | 727-642-3547
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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 | SW 8777
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License Number State | FL
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