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NPI Code Detail

MEDICARE: JILLIAN NAZARENKO LCSW

MEDICARE:   JILLIAN  NAZARENKO  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
1104100000XSocial Worker

General Provider Information

NPI Number : 1528687431
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILLIAN NAZARENKO LCSW
Provider Business Mailing Address
First Line : 2430 ESTANCIA BLVD STE 106
Second Line :
City : CLEARWATER
State : FL
Zip : 33761-2607
Country : US
Telephone Number : 484-222-0067
Fax Number :
Provider Business Practice Location Address
First Line : 2430 ESTANCIA BLVD STE 106
Second Line :
City : CLEARWATER
State : FL
Zip : 33761-2607
Country : US
Telephone Number : 484-222-0067
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2020
Last Update Date : 12/20/2025

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