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NPI Code Detail

MEDICARE: CARLY LOOR LCSW

MEDICARE:   CARLY  LOOR  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 WorkerSC16213FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821695990
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLY LOOR LCSW
Provider Business Mailing Address
First Line : 3781 ROAN CT E
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33403-1019
Country : US
Telephone Number : 561-602-1219
Fax Number :
Provider Business Practice Location Address
First Line : 3781 ROAN CT E
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33403-1019
Country : US
Telephone Number : 561-602-1219
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2020
Last Update Date : 11/10/2020

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Directions to “ CARLY LOOR LCSW” Practice Location

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