| Jeannette Dipento Lcsw Inc | |
|
5700 Lake Worth Road Suite 110 Greenacres FL 33463-3213 | |
| (561) 963-0212 | |
| (561) 434-1615 |
| Full Name | Jeannette Dipento Lcsw Inc |
|---|---|
| Speciality | Social Worker |
| Location | 5700 Lake Worth Road, Greenacres, Florida |
| Authorized Official Name and Position | Jeannette Dipento (OWNER/LCSW) |
| Authorized Official Contact | 5619630212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeannette Dipento Lcsw Inc 5700 Lake Worth Road Suite 110 Greenacres FL 33463-3213 Ph: (561) 963-0212 | Jeannette Dipento Lcsw Inc 5700 Lake Worth Road Suite 110 Greenacres FL 33463-3213 Ph: (561) 963-0212 |
| NPI Number | 1912323791 |
|---|---|
| Provider Enumeration Date | 03/17/2014 |
| Last Update Date | 12/12/2019 |
| Certification Date | 12/12/2019 |
| Medicare PECOS PAC ID | 7618109331 |
|---|---|
| Medicare Enrollment ID | O20140411001427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912323791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW 2472 (Florida) | Primary |
| Provider Name | Jeannette Dipento |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770649576 PECOS PAC ID: 0143487983 Enrollment ID: I20120206000441 |
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