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NPI Code Detail

MEDICARE: PROF. SHERRI ISSA LCSW

MEDICARE: PROF. SHERRI ISSA 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 WorkerSW6069FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Z0803AOTHERFLMEDICARE PART B

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730164914
Entity Type Code : Individual
Provider Name (Legal Business Name) : PROF. SHERRI ISSA LCSW
Provider Business Mailing Address
First Line : 2808 NE 22ND ST
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33305-2804
Country : US
Telephone Number : 954-564-9460
Fax Number : 954-564-1371
Provider Business Practice Location Address
First Line : 2808 NE 22ND ST
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33305-2804
Country : US
Telephone Number : 954-564-9460
Fax Number : 954-564-1371
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2005
Last Update Date : 09/22/2011

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Directions to “ PROF. SHERRI ISSA LCSW” Practice Location

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