Provider Demographics
NPI:1629126735
Name:BIRD, JO-ANN H (PHD, LMHC, NCC)
Entity Type:Individual
Prefix:DR
First Name:JO-ANN
Middle Name:H
Last Name:BIRD
Suffix:
Gender:F
Credentials:PHD, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6820 SUMMER COVE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-8954
Mailing Address - Country:US
Mailing Address - Phone:813-672-9789
Mailing Address - Fax:
Practice Address - Street 1:8019 N HIMES AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2712
Practice Address - Country:US
Practice Address - Phone:813-361-4552
Practice Address - Fax:813-933-4265
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 6090101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health