MEDICARE: MS. CAROL ANN SCHENCK MSW

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	104100000X	Social Worker		FL

General Provider Information

NPI Number	:	1215444658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROL ANN SCHENCK MSW

Provider Business Mailing Address
First Line	:	1581 MIZELL AVE
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-5133
Country	:	US
Telephone Number	:	407-697-1930
Fax Number	:

Provider Business Practice Location Address
First Line	:	1581 MIZELL AVE
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-5133
Country	:	US
Telephone Number	:	407-697-1930
Fax Number	:

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

Provider Enumeration Date	:	01/08/2018
Last Update Date	:	03/17/2018

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