MEDICARE: ELIZABETH VAH 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	58.013564	CT
2	1041C0700X	Clinical Social Worker	0904013229	VA
3	1041C0700X	Clinical Social Worker	55614	TX
4	1041C0700X	Clinical Social Worker	SW10407	FL
5	1041C0700X	Clinical Social Worker	LCSW-20846	AZ
6	1041C0700X	Clinical Social Worker	121186	CA
7	1041C0700X	Clinical Social Worker	CSW009007	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265786404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH VAH LCSW

Provider Business Mailing Address
First Line	:	7901 4TH ST N STE 300
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33702-4399
Country	:	US
Telephone Number	:	305-204-6651
Fax Number	:

Provider Business Practice Location Address
First Line	:	2430 VANDERBILT BEACH RD # 281
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-2654
Country	:	US
Telephone Number	:	305-204-6651
Fax Number	:

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

Provider Enumeration Date	:	11/08/2012
Last Update Date	:	06/18/2026

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