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NPI Code Detail

MEDICARE: MS. JOAN E CHILDS LCSW

MEDICARE:  MS. JOAN E CHILDS  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
11041C0700XClinical Social WorkerSW0000622FL

General Provider Information

NPI Number : 1679804538
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JOAN E CHILDS LCSW
Provider Business Mailing Address
First Line : 1040 BAYVIEW DR STE 408
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33304-2542
Country : US
Telephone Number : 954-568-1004
Fax Number : 954-925-2613
Provider Business Practice Location Address
First Line : 1040 BAYVIEW DR
Second Line : 408
City : FT LAUDERDALE
State : FL
Zip : 33304-2522
Country : US
Telephone Number : 954-568-1004
Fax Number : 954-925-9613
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2010
Last Update Date : 01/15/2010

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Directions to “ MS. JOAN E CHILDS LCSW” Practice Location

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