Provider Demographics
NPI:1679947352
Name:WOODS, GINGER E (LCSW)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:E
Last Name:WOODS
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 1:2315 W JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32505-7552
Mailing Address - Country:US
Mailing Address - Phone:850-436-4630
Mailing Address - Fax:850-436-2095
Practice Address - Street 1:5868 CREEK STATION DR BLDG A
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8627
Practice Address - Country:US
Practice Address - Phone:850-478-1244
Practice Address - Fax:850-478-1894
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-18
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 125441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020065200Medicaid
FLKX914OtherMCR
13656075OtherCAQH
FLNXDFCOtherBCBS