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General NPI Number Information
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NPI Number | 1982801767
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Entity Type | Individual
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Provider Name | NANETTE VITALE LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 05/25/2022
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Provider Practice Location Address
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Address Line | 5350 ATLANTIC AVE STE 106
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8112
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Country | US
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Telephone | 561-638-9219
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Fax | 888-714-0574
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Provider Business Mailing Address
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Address Line | 7915 4TH AVE W
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City | BRADENTON
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State | FL
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Zip | 34209-3253
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Country | US
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Telephone | 954-240-4910
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Fax | 888-714-0574
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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 8682
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License Number State | FL
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