Provider Demographics
NPI:1306397765
Name:LUCILLE GIACONE-KLEIN LCSW CORP
Entity Type:Organization
Organization Name:LUCILLE GIACONE-KLEIN LCSW CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUCILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIACONE-KLEIN LCSW CORP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-389-2283
Mailing Address - Street 1:15175 93RD ST N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-1798
Mailing Address - Country:US
Mailing Address - Phone:561-389-2283
Mailing Address - Fax:
Practice Address - Street 1:1645 PALM BEACH LAKES BLVD STE 440
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2217
Practice Address - Country:US
Practice Address - Phone:561-389-2283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL59911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty