Provider Demographics
NPI:1982801767
Name:VITALE, NANETTE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NANETTE
Middle Name:
Last Name:VITALE
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 1:7915 4TH AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-3253
Mailing Address - Country:US
Mailing Address - Phone:954-240-4910
Mailing Address - Fax:888-714-0574
Practice Address - Street 1:5350 ATLANTIC AVE STE 106
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8112
Practice Address - Country:US
Practice Address - Phone:561-638-9219
Practice Address - Fax:888-714-0574
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 86821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical