Provider Demographics
NPI:1417072661
Name:ORR, JO ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:ANN
Last Name:ORR
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:PO BOX 3756
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5656
Mailing Address - Country:US
Mailing Address - Phone:828-386-6000
Mailing Address - Fax:828-386-1142
Practice Address - Street 1:838 STATE FARM RD
Practice Address - Street 2:STE 1
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5307
Practice Address - Country:US
Practice Address - Phone:828-386-6000
Practice Address - Fax:828-386-1142
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0005771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME100238OtherANTHEM