Provider Demographics
NPI:1629211792
Name:LLOYD, JEANNA E (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JEANNA
Middle Name:E
Last Name:LLOYD
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-1513
Mailing Address - Country:US
Mailing Address - Phone:570-439-1562
Mailing Address - Fax:
Practice Address - Street 1:13 WALNUT ST
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-1513
Practice Address - Country:US
Practice Address - Phone:570-439-1562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0146481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical