MEDICARE: DR. JOHANA KUEMERLE-PINILLOS PHD, 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	013433	NC

General Provider Information

NPI Number	:	1720380173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHANA KUEMERLE-PINILLOS PHD, LCSW

Provider Business Mailing Address
First Line	:	46 N WASHINGTON BLVD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34236-5931
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	46 N WASHINGTON BLVD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34236-5931
Country	:	US
Telephone Number	:	941-200-6135
Fax Number	:

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

Provider Enumeration Date	:	11/17/2010
Last Update Date	:	05/03/2025

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