Provider Demographics
NPI:1851002513
Name:IZEAN, CELENE (MSW)
Entity Type:Individual
Prefix:
First Name:CELENE
Middle Name:
Last Name:IZEAN
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 1:2748 S FERN CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-5539
Mailing Address - Country:US
Mailing Address - Phone:407-801-2821
Mailing Address - Fax:
Practice Address - Street 1:2748 S FERN CREEK AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-5539
Practice Address - Country:US
Practice Address - Phone:407-801-2821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health