MEDICARE: LAUREN LYNN SENTOVICH 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	SW22273	FL

General Provider Information

NPI Number	:	1598519639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN LYNN SENTOVICH LCSW

Provider Business Mailing Address
First Line	:	2911 RIPPLEWOOD DR
Second Line	:
City	:	SEFFNER
State	:	FL
Zip	:	33584-6029
Country	:	US
Telephone Number	:	813-608-2254
Fax Number	:

Provider Business Practice Location Address
First Line	:	1134 BELL SHOALS RD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-8813
Country	:	US
Telephone Number	:	813-315-8648
Fax Number	:

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

Provider Enumeration Date	:	04/15/2024
Last Update Date	:	04/15/2024

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