| Diane M. Digeronimo, Lcsw, Pa | |
|
321 Ocean Ave Ste 107 Melbourne Beach FL 32951-2569 | |
| (321) 230-3023 | |
| Not Available |
| Full Name | Diane M. Digeronimo, Lcsw, Pa |
|---|---|
| Speciality | Social Worker |
| Location | 321 Ocean Ave Ste 107, Melbourne Beach, Florida |
| Authorized Official Name and Position | Diane M Digeronimo (PROVIDER) |
| Authorized Official Contact | 3212303023 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane M. Digeronimo, Lcsw, Pa 321 Ocean Ave Ste 107 Melbourne Beach FL 32951-2569 Ph: (321) 230-3023 | Diane M. Digeronimo, Lcsw, Pa 321 Ocean Ave Ste 107 Melbourne Beach FL 32951-2569 Ph: (321) 230-3023 |
| NPI Number | 1699077891 |
|---|---|
| Provider Enumeration Date | 11/22/2010 |
| Last Update Date | 11/18/2024 |
| Certification Date | 11/18/2024 |
| Medicare PECOS PAC ID | 0042496598 |
|---|---|
| Medicare Enrollment ID | O20110517000635 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699077891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW2181 (Florida) | Primary |
| Provider Name | Diane M Digeronimo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083652002 PECOS PAC ID: 0749466290 Enrollment ID: I20110517000681 |
Mindful Living Counseling And Wellness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 504 Ocean Ave Unit 510364, Melbourne Beach, FL 32951 Phone: 470-387-1878 |