MEDICARE: ETTA F. ETTLINGER 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	LCSW6310	FL

General Provider Information

NPI Number	:	1144207713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ETTA F. ETTLINGER LCSW

Provider Business Mailing Address
First Line	:	100 EXECUTIVE WAY
Second Line	:	SUITE #110
City	:	PONTE VEDRA
State	:	FL
Zip	:	32082-4753
Country	:	US
Telephone Number	:	904-273-4099
Fax Number	:	904-273-4095

Provider Business Practice Location Address
First Line	:	100 EXECUTIVE WAY
Second Line	:	SUITE #110
City	:	PONTE VEDRA
State	:	FL
Zip	:	32082-4753
Country	:	US
Telephone Number	:	904-273-4099
Fax Number	:	904-273-4095

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

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	07/09/2007

Similar Medicare Providers

1134235641 — DR. JANICE WACHTEL PH.D.
Practice Location Address:

100 EXECUTIVE WAY , STE 110
PONTE VEDRA BEACH, FL
32082-4753

Practice Phone: 904-834-2235
Practice Fax: 866-531-8858

1932384351 — ETTA ETTLINGER, LCSW, PA
Practice Location Address:

100 EXECUTIVE WAY STE 110
PONTE VEDRA, FL
32082-4753

Practice Phone: 904-273-4099
Practice Fax: 904-273-4095

1881995140 — AMY LYN GROBSTICK ARNP
Practice Location Address:

868 SHORELINE CIR
PONTE VEDRA BEACH, FL
32082-2741

Practice Phone: 904-866-9551
Practice Fax: 904-542-7346

1821935065 — DAWSON MATTHEW HEY
Practice Location Address:

120 SR-A1A S , STE 101
PONTE VEDRA BEACH, FL
32082

Practice Phone: 904-280-9000
Practice Fax:

1306849336 — DR. ERIC L TOWNSEND DDS
Practice Location Address:

105 SOLANA RD , STE A
PONTE VEDRA, FL
32082-5229

Practice Phone: 904-285-7711
Practice Fax: 904-285-3604

1336146653 — DR. BONNIE K WHITE MD
Practice Location Address:

1100 SAWGRASS VILLAGE DR , SUITE 100
PONTE VEDRA BEACH, FL
32082-5048

Practice Phone: 904-285-9355
Practice Fax: 904-285-7442

Directions to “ ETTA F. ETTLINGER LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.