Provider Demographics
NPI:1417439316
Name:DENISE PALTER LCSW PLLC
Entity Type:Organization
Organization Name:DENISE PALTER LCSW PLLC
Other - Org Name:DENISE PALTERLCSW PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:PALTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-759-3417
Mailing Address - Street 1:605 W BLOOMINGDALE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-7405
Mailing Address - Country:US
Mailing Address - Phone:813-759-3417
Mailing Address - Fax:
Practice Address - Street 1:605 W BLOOMINGDALE AVE STE B
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-7405
Practice Address - Country:US
Practice Address - Phone:813-759-3417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty