Provider Demographics
NPI:1174009211
Name:WOODARD, JO-ANNE SPENCER (LMSW, ACSW)
Entity Type:Individual
Prefix:MS
First Name:JO-ANNE
Middle Name:SPENCER
Last Name:WOODARD
Suffix:
Gender:F
Credentials:LMSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23300 GREENFIELD
Mailing Address - Street 2:SUITE 122
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237
Mailing Address - Country:US
Mailing Address - Phone:248-968-9508
Mailing Address - Fax:248-968-9516
Practice Address - Street 1:23300 GREENFIELD
Practice Address - Street 2:SUITE 122
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237
Practice Address - Country:US
Practice Address - Phone:248-968-9508
Practice Address - Fax:248-968-9516
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801035858104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker