Provider Demographics
NPI:1992184428
Name:ILENE A SCHARF, MSW, LCSW, INC
Entity Type:Organization
Organization Name:ILENE A SCHARF, MSW, LCSW, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ILENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHARF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:321-421-6982
Mailing Address - Street 1:3425 SHADY RUN RD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-8569
Mailing Address - Country:US
Mailing Address - Phone:321-446-3603
Mailing Address - Fax:
Practice Address - Street 1:6767 N WICKHAM RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-2031
Practice Address - Country:US
Practice Address - Phone:321-421-6982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL767381700Medicaid