Bologna, Daniel Louis

Bologna, Daniel Louis is an individual health care provider with primary practice located at 840 Brevard Ave , Rockledge FL 32955-2149. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bologna, Daniel Louis can be contacted via phone (321) 632-5792.

Contact Information

Primary practice address
840 Brevard Ave Rockledge FL 32955-2149
Phone: (321) 632-5792
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW000254 Florida

Profile Details

NPI number 1508990896
LBN Legal business name Bologna, Daniel Louis
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2007
Last updated Jun 9th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508990896 NPPES
Florida Other 62-40039 UNITED HEALTH CARE
Florida Other 275862 UNITED HEALTH CARE
Florida MEDICAID 060332500 UNITED HEALTH CARE

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