Provider Demographics
NPI:1467770099
Name:OGDEN, JANE B (LCSW)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:B
Last Name:OGDEN
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 14309
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34280-4309
Mailing Address - Country:US
Mailing Address - Phone:941-713-5913
Mailing Address - Fax:
Practice Address - Street 1:6404 MANATEE AVE W
Practice Address - Street 2:SUITE B
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-2379
Practice Address - Country:US
Practice Address - Phone:941-713-5913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 97461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical