Provider Demographics
NPI:1063645414
Name:HOLLINGSWORTH, JOLENE (LCSW)
Entity Type:Individual
Prefix:
First Name:JOLENE
Middle Name:
Last Name:HOLLINGSWORTH
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 1:7635 ASHLEY PARK CT
Mailing Address - Street 2:SUITE 503-K
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6195
Mailing Address - Country:US
Mailing Address - Phone:407-595-8530
Mailing Address - Fax:407-296-2286
Practice Address - Street 1:7635 ASHLEY PARK CT
Practice Address - Street 2:SUITE 503-K
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6195
Practice Address - Country:US
Practice Address - Phone:407-595-8530
Practice Address - Fax:407-296-2286
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW9387104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker