Provider Demographics
NPI:1689890782
Name:SQUILLANTE, JANE MARIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:MARIE
Last Name:SQUILLANTE
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JANE
Other - Middle Name:MARIE
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 SW 78TH AVE APT 1227
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3383
Mailing Address - Country:US
Mailing Address - Phone:954-980-5464
Mailing Address - Fax:
Practice Address - Street 1:1111 W BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-1638
Practice Address - Country:US
Practice Address - Phone:954-980-5464
Practice Address - Fax:954-527-6031
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 59131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical