Provider Demographics
NPI:1003013475
Name:BLOCK, JOANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:
Last Name:BLOCK
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 1:4131 N.W.. 28TH LANE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606
Mailing Address - Country:US
Mailing Address - Phone:352-375-3001
Mailing Address - Fax:352-375-1003
Practice Address - Street 1:4131 NW 28TH LN
Practice Address - Street 2:SUITE 6
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7432
Practice Address - Country:US
Practice Address - Phone:352-375-3001
Practice Address - Fax:352-375-1003
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW1481041C0700X
FLMT107106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ-0961OtherBCBS
FLZ-0961OtherBCBS