Provider Demographics
NPI:1912323791
Name:JEANNETTE DIPENTO LCSW INC
Entity Type:Organization
Organization Name:JEANNETTE DIPENTO LCSW INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LCSW
Authorized Official - Prefix:
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIPENTO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-963-0212
Mailing Address - Street 1:5700 LAKE WORTH ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3213
Mailing Address - Country:US
Mailing Address - Phone:561-963-0212
Mailing Address - Fax:561-434-1615
Practice Address - Street 1:5700 LAKE WORTH ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3213
Practice Address - Country:US
Practice Address - Phone:561-963-0212
Practice Address - Fax:561-434-1615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-17
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 24721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty