Provider Demographics
NPI:1093291833
Name:STETTER-COBLENTZ, NANCY J (LCSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:STETTER-COBLENTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:J
Other - Last Name:STETTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1790 E VENICE AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-3191
Mailing Address - Country:US
Mailing Address - Phone:941-488-8884
Mailing Address - Fax:941-488-5554
Practice Address - Street 1:1790 E VENICE AVE STE 204
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-3191
Practice Address - Country:US
Practice Address - Phone:941-488-8884
Practice Address - Fax:941-488-5554
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW154281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical