MEDICARE: MS. JANE YOUNG ARTHUR 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	SW2312	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10745043	OTHER	FL	COUNCIL FOR AFFORDABLE QUALITY HEALTH CARE

General Provider Information

NPI Number	:	1255651766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANE YOUNG ARTHUR LCSW

Provider Business Mailing Address
First Line	:	PO BOX 2028
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-2028
Country	:	US
Telephone Number	:	813-504-1462
Fax Number	:	813-996-9705

Provider Business Practice Location Address
First Line	:	3632 LAND O LAKES BLVD
Second Line	:	SUITE 106-5
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-4405
Country	:	US
Telephone Number	:	813-504-1462
Fax Number	:	813-996-9705

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

Provider Enumeration Date	:	06/07/2010
Last Update Date	:	02/19/2011

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