Provider Demographics
NPI:1639131782
Name:FLYNN, JOAN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:ELIZABETH
Last Name:FLYNN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JOAN
Other - Middle Name:ELIZABETH
Other - Last Name:SHAUGHNESSY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25166 MARION AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-4052
Mailing Address - Country:US
Mailing Address - Phone:941-205-3333
Mailing Address - Fax:941-205-3334
Practice Address - Street 1:1790 E VENICE AVE STE 204
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-3191
Practice Address - Country:US
Practice Address - Phone:941-488-8884
Practice Address - Fax:941-488-5554
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL77831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical