Provider Demographics
NPI:1689203770
Name:WOOLSEY, JOANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:WOOLSEY
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 1:437 CIRCLEWAY DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-3126
Mailing Address - Country:US
Mailing Address - Phone:435-229-8808
Mailing Address - Fax:
Practice Address - Street 1:535 S MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-3574
Practice Address - Country:US
Practice Address - Phone:435-229-8808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
141660-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical