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NPI Code Detail

MEDICARE: EMILY DIANE SAMUELS LCSW

MEDICARE:   EMILY DIANE SAMUELS  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
11041C0700XClinical Social WorkerSW1747FL

General Provider Information

NPI Number : 1154636827
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY DIANE SAMUELS LCSW
Provider Business Mailing Address
First Line : 934 N UNIVERSITY DR
Second Line : PMB 206
City : CORAL SPRINGS
State : FL
Zip : 33071-7029
Country : US
Telephone Number : 954-885-9500
Fax Number : 954-885-9444
Provider Business Practice Location Address
First Line : 3349 N UNIVERSITY DR
Second Line : SUITE 4
City : HOLLYWOOD
State : FL
Zip : 33024-9000
Country : US
Telephone Number : 954-885-9500
Fax Number : 954-885-9444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2010
Last Update Date : 08/18/2010

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Directions to “ EMILY DIANE SAMUELS LCSW” Practice Location

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