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MARK JAMES CARDILLO LCSW

>> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1366544991

Individual Registrant:
 MARK JAMES CARDILLO LCSW
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1232 N PINELLAS AVE  TARPON SPRINGS, FL 34689 US
Tel: 727-944-5171  Fax: 722-944-5174

Contact information for business:
433 4TH ST NORTH  ST PETERSBURG, FL 33701 US
Tel: 727-895-8499  Fax: 727-895-8497

Registration Information:
NPI: 1366544991
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y104100000XBehavioral Health & Social Service Providers
Social Worker
FLSW4722

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MEDICARE PART B GROUP NUMK452601




HEALTH CARE JOBS FL - Page 1



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