Provider Demographics
NPI:1336654425
Name:NOLAN, JENNE (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNE
Middle Name:
Last Name:NOLAN
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 1:20016 NE 6TH COURT CIR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-2406
Mailing Address - Country:US
Mailing Address - Phone:786-523-3476
Mailing Address - Fax:
Practice Address - Street 1:20016 NE 6TH COURT CIR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2406
Practice Address - Country:US
Practice Address - Phone:786-523-3476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health