Provider Demographics
NPI:1063181386
Name:VARSAM, JOHN MICHAEL (LCSW, ICGC-II, IGDC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MICHAEL
Last Name:VARSAM
Suffix:
Gender:M
Credentials:LCSW, ICGC-II, IGDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 N FEDERAL HWY STE 210
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-5195
Mailing Address - Country:US
Mailing Address - Phone:561-600-8240
Mailing Address - Fax:
Practice Address - Street 1:4400 N FEDERAL HWY
Practice Address - Street 2:SUITE 210
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431
Practice Address - Country:US
Practice Address - Phone:561-600-8240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical