MEDICARE: MS. BETH LARSON WARRINER 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	SW1388	FL
2	1041C0700X	Clinical Social Worker	007328	SC

General Provider Information

NPI Number	:	1700831641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BETH LARSON WARRINER LCSW

Provider Business Mailing Address
First Line	:	4923 COMMONWEALTH DR
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34242-1421
Country	:	US
Telephone Number	:	941-346-0814
Fax Number	:	941-349-1013

Provider Business Practice Location Address
First Line	:	4923 COMMONWEALTH DR
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34242-1421
Country	:	US
Telephone Number	:	941-346-0814
Fax Number	:	941-349-1013

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	07/08/2007

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