Provider Demographics
NPI:1700831641
Name:WARRINER, BETH LARSON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:LARSON
Last Name:WARRINER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4923 COMMONWEALTH DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34242-1421
Mailing Address - Country:US
Mailing Address - Phone:941-346-0814
Mailing Address - Fax:941-349-1013
Practice Address - Street 1:4923 COMMONWEALTH DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34242-1421
Practice Address - Country:US
Practice Address - Phone:941-346-0814
Practice Address - Fax:941-349-1013
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW13881041C0700X
SC0073281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ4885Medicare ID - Type UnspecifiedLCSW