MEDICARE: MS. LORI SARVIS 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	SW2627	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023091675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LORI SARVIS LCSW

Provider Business Mailing Address
First Line	:	2151 W HILLSBORO BLVD
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-1275
Country	:	US
Telephone Number	:	954-426-0410
Fax Number	:	954-596-4822

Provider Business Practice Location Address
First Line	:	2151 W HILLSBORO BLVD STE 203
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-1275
Country	:	US
Telephone Number	:	954-426-0410
Fax Number	:	954-596-4822

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

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	02/27/2019

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