Provider Demographics
NPI:1730130600
Name:NELSON, JOANNE LYNN (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:LYNN
Last Name:NELSON
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2461 W STATE ROAD 426
Mailing Address - Street 2:SUITE 2055
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-4508
Mailing Address - Country:US
Mailing Address - Phone:407-359-1181
Mailing Address - Fax:407-359-1931
Practice Address - Street 1:2461 W STATE ROAD 426
Practice Address - Street 2:SUITE 2055
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-4508
Practice Address - Country:US
Practice Address - Phone:407-359-1181
Practice Address - Fax:407-359-1931
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW55351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical