Provider Demographics
NPI:1437460672
Name:GREENBLATT, DONI (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DONI
Middle Name:
Last Name:GREENBLATT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22310 GUADELOUPE ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-4939
Mailing Address - Country:US
Mailing Address - Phone:561-347-5025
Mailing Address - Fax:
Practice Address - Street 1:22310 GUADELOUPE ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-4939
Practice Address - Country:US
Practice Address - Phone:561-347-5025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW90911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical