Provider Demographics
NPI:1447217799
Name:SCHARF, ILENE A (LCSW)
Entity type:Individual
Prefix:
First Name:ILENE
Middle Name:A
Last Name:SCHARF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 SHADY RUN RD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-8569
Mailing Address - Country:US
Mailing Address - Phone:321-446-3603
Mailing Address - Fax:
Practice Address - Street 1:6767 N WICKHAM RD
Practice Address - Street 2:SUITE 400
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-2031
Practice Address - Country:US
Practice Address - Phone:321-421-6982
Practice Address - Fax:321-255-7598
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 64791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ037GOtherBCBS
FLE7607OtherMEDICARE - SUPPLIER