Provider Demographics
NPI:1346580123
Name:MICHAEL, JOCELYN (BSW)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3242 S SENSENEY CIR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-8123
Mailing Address - Country:US
Mailing Address - Phone:423-915-6529
Mailing Address - Fax:
Practice Address - Street 1:1820 MEMORIAL CIR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4539
Practice Address - Country:US
Practice Address - Phone:931-920-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator