MEDICARE: MS. ROSCIARA S. PUGH 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	101YM0800X	Mental Health Counselor	ISW9241	FL
2	101YM0800X	Mental Health Counselor	SW14419	FL

General Provider Information

NPI Number	:	1013315134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROSCIARA S. PUGH LCSW

Provider Business Mailing Address
First Line	:	7750 OKEECHOBEE BOULEVARD SUITE #4-730
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411
Country	:	US
Telephone Number	:	561-299-4571
Fax Number	:

Provider Business Practice Location Address
First Line	:	7750 OKEECHOBEE BOULEVARD SUITE #4-730
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411
Country	:	US
Telephone Number	:	561-299-4571
Fax Number	:

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

Provider Enumeration Date	:	12/06/2014
Last Update Date	:	05/11/2021

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