MEDICARE: STEPHANIE J GOOSSENS ALAYON 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	SW20600	FL

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	:	1447968342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE J GOOSSENS ALAYON LCSW

Provider Business Mailing Address
First Line	:	1127 ROYAL PALM BEACH BLVD # 128
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-1641
Country	:	US
Telephone Number	:	561-440-7678
Fax Number	:	561-440-7678

Provider Business Practice Location Address
First Line	:	1127 ROYAL PALM BEACH BLVD # 128
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-1641
Country	:	US
Telephone Number	:	561-440-7678
Fax Number	:	561-440-7678

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

Provider Enumeration Date	:	11/09/2022
Last Update Date	:	04/11/2024

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