MEDICARE: MRS. SANDRA JOYCE BILLINGS 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	SW2575	FL

General Provider Information

NPI Number	:	1821081084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SANDRA JOYCE BILLINGS LCSW

Provider Business Mailing Address
First Line	:	1027 W LAKE DAMON DR
Second Line	:
City	:	AVON PARK
State	:	FL
Zip	:	33825-8954
Country	:	US
Telephone Number	:	863-453-4161
Fax Number	:	863-453-4161

Provider Business Practice Location Address
First Line	:	930 W MAIN ST
Second Line	:
City	:	AVON PARK
State	:	FL
Zip	:	33825-3312
Country	:	US
Telephone Number	:	863-453-4161
Fax Number	:	863-453-4161

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	09/23/2013

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