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General NPI Number Information
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NPI Number | 1598092827
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Entity Type | Organization
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Legal Business Name | DENISE LEDERMAN LCSW, LNC, PA
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Dates
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Enumeration Date | 11/06/2009
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Last Update Date | 11/06/2009
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Provider Practice Location Address
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Address Line | 36000 PORTOFINO CIR SUITE 114
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-1284
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Country | US
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Telephone | 954-234-9018
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Fax |
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Provider Business Mailing Address
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Address Line | 36000 PORTOFINO CIR SUITE 114
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-1284
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Country | US
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Telephone | 954-234-9018
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DENISE RENEE LEDERMAN
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Credential | LCSW
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Telephone | 954-234-9018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | SW4939
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License Number State | FL
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