Provider Demographics
NPI:1235869454
Name:DIAZ-FRANCO, JESSE ALBERT I (LCSW)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:ALBERT
Last Name:DIAZ-FRANCO
Suffix:I
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8380 PHILADELPHIA AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-5452
Mailing Address - Country:US
Mailing Address - Phone:352-585-0626
Mailing Address - Fax:
Practice Address - Street 1:1750 ARCADIA RD
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34690-6052
Practice Address - Country:US
Practice Address - Phone:727-939-8387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-11
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SW200301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical