| Carol Wishnov Lcsw | |
|
22722 Meridiana Dr Boca Raton FL 33433-6313 | |
| (561) 289-2550 | |
| Not Available |
| Full Name | Carol Wishnov Lcsw |
|---|---|
| Speciality | Social Worker |
| Location | 22722 Meridiana Dr, Boca Raton, Florida |
| Authorized Official Name and Position | Carol Ann Wishnov (MANAGER) |
| Authorized Official Contact | 5612892660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carol Wishnov Lcsw 22722 Meridiana Dr Boca Raton FL 33433-6313 Ph: (561) 289-2550 | Carol Wishnov Lcsw 22722 Meridiana Dr Boca Raton FL 33433-6313 Ph: (561) 289-2550 |
| NPI Number | 1548631484 |
|---|---|
| Provider Enumeration Date | 10/19/2015 |
| Last Update Date | 12/08/2023 |
| Certification Date | 12/08/2023 |
| Medicare PECOS PAC ID | 8123322641 |
|---|---|
| Medicare Enrollment ID | O20160203002047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548631484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW13177 (Florida) | Primary |
| Provider Name | Carol A Wishnov |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962837997 PECOS PAC ID: 4385948801 Enrollment ID: I20160203002238 |
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