Provider Demographics
NPI:1972927952
Name:LIFSHUTZ, NEIL (LCSW)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:LIFSHUTZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 PECAN DRIVE LOOP
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-6249
Mailing Address - Country:US
Mailing Address - Phone:954-661-3931
Mailing Address - Fax:
Practice Address - Street 1:1515 E SILVER SPRINGS BLVD
Practice Address - Street 2:SUITE 226
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6831
Practice Address - Country:US
Practice Address - Phone:352-369-3320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW61641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical