Provider Demographics
NPI:1598092827
Name:DENISE LEDERMAN LCSW, LNC, PA
Entity Type:Organization
Organization Name:DENISE LEDERMAN LCSW, LNC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:LEDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:954-234-9018
Mailing Address - Street 1:36000 PORTOFINO CIR
Mailing Address - Street 2:SUITE 114
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-1284
Mailing Address - Country:US
Mailing Address - Phone:954-234-9018
Mailing Address - Fax:
Practice Address - Street 1:36000 PORTOFINO CIR
Practice Address - Street 2:SUITE 114
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-1284
Practice Address - Country:US
Practice Address - Phone:954-234-9018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW4939251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health