MEDICARE: NAZMA NILES 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	SW21689	FL

General Provider Information

NPI Number	:	1023797719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAZMA NILES LCSW

Provider Business Mailing Address
First Line	:	2743 1ST ST
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-1830
Country	:	US
Telephone Number	:	401-203-5247
Fax Number	:

Provider Business Practice Location Address
First Line	:	2743 1ST ST
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-1830
Country	:	US
Telephone Number	:	631-312-4846
Fax Number	:

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

Provider Enumeration Date	:	07/12/2023
Last Update Date	:	07/09/2024

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Directions to “ NAZMA NILES LCSW” Practice Location

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