MEDICARE: CAROLYN FITZGERALD HELLMANN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW11131	FL

General Provider Information

NPI Number	:	1003120668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN FITZGERALD HELLMANN LCSW

Provider Business Mailing Address
First Line	:	PO BOX 118
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34991-0118
Country	:	US
Telephone Number	:	561-346-1590
Fax Number	:

Provider Business Practice Location Address
First Line	:	1207 SW SUNSET TRL
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-3342
Country	:	US
Telephone Number	:	772-486-7249
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2010
Last Update Date	:	08/19/2021

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