Eleanor A Bower, LCSW
Individual provider Active NPI Clinical Social Worker · Bushnell, FL
NPI 1043348253 · NPPES record last updated Sep 20, 2012
Key facts
- NPI
- 1043348253
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- SW 2454 (FL)
- Practice address
- 119 N Market St
Bushnell, FL 33513-6107 - Phone
- (352) 793-4126
- Fax
- (352) 360-6582
- NPI assigned
- Mar 1, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW 2454 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifestream Behavioral Center Inc | Past | Accepting new patients | |
| Lifestream Behavioral Center Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW 2454 | FL | Yes |
Addresses
Primary practice location
119 N Market St
Bushnell, FL 33513-6107
Mailing address
1898 W C 476
Bushnell, FL 33513-3524
Phone (352) 793-4126
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 768183600 | Medicaid | FL | |
| AC851 | Other | FL | MEDICARE PTAN |
Other providers in Bushnell, FL
- Kattia Blanco
- Blessed at Home LLC
- Mary Hyacinth Bodenheimer
- Ronnie-Jane Boekema
- Allison Bootz
- Angel L. Bruno
- Bushnell Family and Cosmetic Dentistry PLLC
- Byt Enterprise LLC
- Carefirst Aco, LLC
- Judy R Carelock
All providers in Bushnell, FL · Clinical Social Worker in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.