Provider Demographics
NPI:1851688659
Name:DESCISCIO, JODI APOLLO (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JODI
Middle Name:APOLLO
Last Name:DESCISCIO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12309 CLOVERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-5730
Mailing Address - Country:US
Mailing Address - Phone:813-817-2709
Mailing Address - Fax:813-968-7370
Practice Address - Street 1:333 S. PLANT AVE.
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606
Practice Address - Country:UM
Practice Address - Phone:813-817-2709
Practice Address - Fax:813-250-3511
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMHC 1549101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional