Provider Demographics
NPI:1053917922
Name:JOANNE JEAN COUNSELING LLC
Entity type:Organization
Organization Name:JOANNE JEAN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:352-234-3208
Mailing Address - Street 1:4417 SW 21ST LN
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-3835
Mailing Address - Country:US
Mailing Address - Phone:813-965-7645
Mailing Address - Fax:
Practice Address - Street 1:500 E UNIVERSITY AVE STE C
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-3458
Practice Address - Country:US
Practice Address - Phone:352-234-3208
Practice Address - Fax:877-875-4912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health