Provider Demographics
NPI:1710027081
Name:WESLEY, LONNIE MAE (MSW)
Entity Type:Individual
Prefix:MISS
First Name:LONNIE
Middle Name:MAE
Last Name:WESLEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 CAPITAL CIR NE
Mailing Address - Street 2:SUITE 206, ALEXIS CENTER
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-0595
Mailing Address - Country:US
Mailing Address - Phone:850-386-2000
Mailing Address - Fax:850-383-1959
Practice Address - Street 1:1725 CAPITAL CIR NE
Practice Address - Street 2:SUITE 206, ALEXIS CENTER
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-0595
Practice Address - Country:US
Practice Address - Phone:850-386-2000
Practice Address - Fax:850-383-1959
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW9251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical