| Carol G Fortune Lcsw Pa | |
|
1522 Golden Ridge Dr The Villages FL 32162-6765 | |
| (352) 638-2264 | |
| (352) 350-7244 |
| Full Name | Carol G Fortune Lcsw Pa |
|---|---|
| Speciality | Social Worker |
| Location | 1522 Golden Ridge Dr, The Villages, Florida |
| Authorized Official Name and Position | Carol G Fortune (OWNER) |
| Authorized Official Contact | 3526382264 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carol G Fortune Lcsw Pa 1522 Golden Ridge Dr The Villages FL 32162-6765 Ph: (352) 638-2264 | Carol G Fortune Lcsw Pa 1522 Golden Ridge Dr The Villages FL 32162-6765 Ph: (352) 638-2264 |
| NPI Number | 1295292472 |
|---|---|
| Provider Enumeration Date | 02/25/2019 |
| Last Update Date | 03/04/2019 |
| Medicare PECOS PAC ID | 2264771575 |
|---|---|
| Medicare Enrollment ID | O20190305000622 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295292472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Carol G Fortune |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578673083 PECOS PAC ID: 4880614361 Enrollment ID: I20060106000124 |
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