MEDICARE: STRATEGIES FOR SOCIAL SUCCESS, LLC

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1780046557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRATEGIES FOR SOCIAL SUCCESS, LLC

Provider Business Mailing Address
First Line	:	115 AZALEA PL
Second Line	:
City	:	NEPTUNE BEACH
State	:	FL
Zip	:	32266-6013
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 AZALEA PL
Second Line	:
City	:	NEPTUNE BEACH
State	:	FL
Zip	:	32266-6013
Country	:	US
Telephone Number	:	352-284-6057
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SARA GIANINO
Credential	:
Telephone Number	:	352-284-6057

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	03/22/2016

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