Jan Ice MSW LCSW P a

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW5007 Issued in FL

Legal business name

JAN ICE MSW LCSW P A

Practice address

1415 Panther LN
Suite 215
Naples, FL 34109-7874

Phone

(239) 591-6626

Fax

(239) 591-6627

NPI assigned

Nov 19, 2008

Last updated

Mar 14, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Jan Ice, MSW LCSW

Title

Psychotherapist

Phone

(239) 273-3915

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236988800000",
    "number": "1033364039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4521 BROADWAY AVE W",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339282624",
            "telephone_number": "239-591-6626",
            "fax_number": "239-591-6627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 PANTHER LN",
            "address_2": "SUITE 215",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341097874",
            "telephone_number": "239-591-6626",
            "fax_number": "239-591-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAN ICE MSW LCSW P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-19",
        "last_updated": "2009-03-14",
        "status": "A",
        "authorized_official_last_name": "ICE",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "239-273-3915",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Naples, FL
• Providers in Naples, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.