Provider Demographics
NPI:1003073693
Name:LOREDANA REPETTO LCSW & ASSOC LLC
Entity Type:Organization
Organization Name:LOREDANA REPETTO LCSW & ASSOC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOREDANA
Authorized Official - Middle Name:
Authorized Official - Last Name:REPETTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-669-3911
Mailing Address - Street 1:2329 SUNSET POINT ROAD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765
Mailing Address - Country:US
Mailing Address - Phone:727-669-3911
Mailing Address - Fax:727-669-3813
Practice Address - Street 1:2329 SUNSET POINT ROAD
Practice Address - Street 2:SUITE 203
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765
Practice Address - Country:US
Practice Address - Phone:727-669-3911
Practice Address - Fax:727-669-3813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW82311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty