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Organization
PRACTICAL SAGE, CLINICAL SOCIAL WORK SERVICES
Active
Organization
PRACTICAL SAGE, CLINICAL SOCIAL WORK SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN GAVITT-RIVERA LCSW (DIRECTOR)
(727) 712-0039
Entity
Organization
Contact information
Practice address
126 3RD AVE N STE 104, SAFETY HARBOR, FL 34695-3658
(727) 712-0039
Mailing address
306 HAMILTON AVE, SAFETY HARBOR, FL 34695-3213
(727) 712-0039
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104967000
—
FL
Enumeration date
04/19/2022
Last updated
10/19/2022
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