MEDICARE: ANDREW PLISNER LMSW

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	092493	NY

General Provider Information

NPI Number	:	1689043234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW PLISNER LMSW

Provider Business Mailing Address
First Line	:	819 6TH ST N APT 1
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33701-2276
Country	:	US
Telephone Number	:	313-410-8731
Fax Number	:

Provider Business Practice Location Address
First Line	:	819 6TH ST N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33701-2276
Country	:	US
Telephone Number	:	914-713-5616
Fax Number	:

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

Provider Enumeration Date	:	09/24/2015
Last Update Date	:	07/05/2023

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