Provider Demographics
NPI:1801923552
Name:ISAACS, SAMUEL GILBERT (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:GILBERT
Last Name:ISAACS
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7590 MIRABELLA DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-6131
Mailing Address - Country:US
Mailing Address - Phone:561-239-9928
Mailing Address - Fax:
Practice Address - Street 1:2300 GLADES RD STE 205EAST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7386
Practice Address - Country:US
Practice Address - Phone:561-338-5260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW15871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ2115AMedicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER