Provider Demographics
NPI:1538233523
Name:NAOMI S. KORN, L.C.S.W.
Entity type:Organization
Organization Name:NAOMI S. KORN, L.C.S.W.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:S
Authorized Official - Last Name:KORN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:727-894-6501
Mailing Address - Street 1:535 CENTRAL AVE STE 316
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3703
Mailing Address - Country:US
Mailing Address - Phone:727-894-6501
Mailing Address - Fax:727-821-6440
Practice Address - Street 1:535 CENTRAL AVE STE 316
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3703
Practice Address - Country:US
Practice Address - Phone:727-894-6501
Practice Address - Fax:727-821-6440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW5681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ1319Medicare ID - Type UnspecifiedLCSW