Provider Demographics
NPI:1922089853
Name:TOMASO-WOOD, JUNE H (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:H
Last Name:TOMASO-WOOD
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 1:269 VENICE PALMS BLVD
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-2449
Mailing Address - Country:US
Mailing Address - Phone:941-284-4268
Mailing Address - Fax:941-484-4076
Practice Address - Street 1:269 VENICE PALMS BLVD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-2449
Practice Address - Country:US
Practice Address - Phone:941-284-4268
Practice Address - Fax:941-484-4076
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW68251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU2736Medicare ID - Type UnspecifiedLCSW