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General NPI Number Information
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NPI Number | 1659646453
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Entity Type | Organization
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Legal Business Name | CAROLE FLASTER LCSW PA
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Dates
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Enumeration Date | 03/13/2012
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 5400 S UNIVERSITY DRIVE SUITE 207
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City | DAVIE
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State | FL
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Zip | 33328-5309
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Country | US
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Telephone | 954-370-3335
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Fax | 954-370-3353
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Provider Business Mailing Address
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Address Line | 5400 S UNIVERSITY DRIVE SUITE 207
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City | DAVIE
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State | FL
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Zip | 33328-5309
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Country | US
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Telephone | 954-370-3335
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Fax | 954-370-3353
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Authorized Official
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Title or Position | OWNER
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Name | CAROLE FLASTER
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Credential |
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Telephone | 954-370-3335
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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 | SW850
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT415
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License Number State | FL
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