Provider Demographics
NPI:1134107394
Name:BEMENT, JOANNA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:
Last Name:BEMENT
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 1:340 MAGNOLIA CIR BLDG 1465A
Mailing Address - Street 2:
Mailing Address - City:TYNDALL AFB
Mailing Address - State:FL
Mailing Address - Zip Code:32403-5604
Mailing Address - Country:US
Mailing Address - Phone:317-730-1662
Mailing Address - Fax:
Practice Address - Street 1:340 MAGNOLIA CIR BLDG 1465A
Practice Address - Street 2:
Practice Address - City:TYNDALL AFB
Practice Address - State:FL
Practice Address - Zip Code:32403-5604
Practice Address - Country:US
Practice Address - Phone:317-730-1662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN50081041C0700X
IN34003323A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN233433000OtherMAGELLAN
IN000000205818OtherANTHEM BCBS
IN2004103OtherCIGNA
IN000000345393OtherANTHEM BCBS
IN233433000OtherMAGELLAN
IN000000205818OtherANTHEM BCBS