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General NPI Number Information
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NPI Number | 1710562848
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Entity Type | Organization
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Legal Business Name | LOLA BROGNANO, LCSW, LLC
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 01/17/2022
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Provider Practice Location Address
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Address Line | 1882 CAPITAL CIR NE STE 201
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4568
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Country | US
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Telephone | 850-888-0136
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Fax |
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Provider Business Mailing Address
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Address Line | 491 TEAL LN APT A
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4742
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Country | US
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Telephone | 920-860-1938
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | LAUREN BROGNANO
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Credential |
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Telephone | 920-860-1938
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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 |
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License Number State |
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