Provider Demographics
NPI:1871784132
Name:BEZMEN-GOLDSTEIN, CAROLE A (MSW,LCSW)
Entity type:Individual
Prefix:MRS
First Name:CAROLE
Middle Name:A
Last Name:BEZMEN-GOLDSTEIN
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:MS
Other - First Name:CAROLE
Other - Middle Name:A
Other - Last Name:BEZMEN-GOLDSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:704 E GRAND HWY
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-3708
Mailing Address - Country:US
Mailing Address - Phone:352-346-0753
Mailing Address - Fax:352-708-5311
Practice Address - Street 1:704 E GRAND HWY
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-3708
Practice Address - Country:US
Practice Address - Phone:352-642-0753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW135361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical