MEDICARE: MS. CAROLE SUNDELL RAJAN MSW, 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	SW3020	FL

General Provider Information

NPI Number	:	1396725669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROLE SUNDELL RAJAN MSW, LCSW

Provider Business Mailing Address
First Line	:	4362 NORTHLAKE BLVD
Second Line	:	SUITE 110
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-6275
Country	:	US
Telephone Number	:	561-694-1887
Fax Number	:	561-626-2131

Provider Business Practice Location Address
First Line	:	4362 NORTHLAKE BLVD
Second Line	:	SUITE 110
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-6275
Country	:	US
Telephone Number	:	561-694-1887
Fax Number	:	561-626-2131

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

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	07/08/2007

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