MEDICARE: STEPHANIE NICOLE CATALANO 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	LCSW15073	FL

General Provider Information

NPI Number	:	1992213029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE NICOLE CATALANO LCSW

Provider Business Mailing Address
First Line	:	500 E LAS OLAS BLVD APT 2701
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33301-2582
Country	:	US
Telephone Number	:	305-747-7874
Fax Number	:	754-206-3730

Provider Business Practice Location Address
First Line	:	2500 N FEDERAL HWY STE 3
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33305-1618
Country	:	US
Telephone Number	:	305-747-7874
Fax Number	:	754-206-3730

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

Provider Enumeration Date	:	01/10/2018
Last Update Date	:	01/10/2018

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