MEDICARE: NINA KOSUBEVSKY 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	SW24827	FL

General Provider Information

NPI Number	:	1780578583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NINA KOSUBEVSKY LCSW

Provider Business Mailing Address
First Line	:	1201 US HIGHWAY 1 STE 330
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-8508
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 US HIGHWAY 1 STE 330
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-8508
Country	:	US
Telephone Number	:	561-472-0397
Fax Number	:

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

Provider Enumeration Date	:	06/05/2025
Last Update Date	:	06/05/2025

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