Individual provider · NPI-1

Steven P Agelidis, LCSW, MCAP

Social Worker, Clinical · Lakeland, FL

NPI number1861964819
StatusActive
Last updated in NPPESJul 15, 2020

Details

NPI
1861964819
Entity type
Individual (NPI-1)
Name
Steven P Agelidis
Credential
LCSW, MCAP
Sex
Male
Sole proprietor
No
Enumeration date
Dec 31, 2018
Certification date
Jul 15, 2020
Last updated
Jul 15, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical17391FLYes
101YA0400X Counselor, Addiction (Substance Use Disorder)MCAP100295FL

Practice location

2020 S. Florida Ave
Suite 207
Lakeland, FL 33803

Phone 813-290-8560 · Fax 863-583-0392

Mailing address

2020 S. Florida Avenue
Suite 207
Lakeland, FL 33803

Phone 813-290-8560 · Fax 863-583-0392

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