Provider Demographics
NPI:1922211374
Name:BLUMENTHAL, JOANN (LMHC)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:BLUMENTHAL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6930 HUNTINGTON LAKES CIR
Mailing Address - Street 2:202
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-7983
Mailing Address - Country:US
Mailing Address - Phone:239-949-2300
Mailing Address - Fax:239-597-0724
Practice Address - Street 1:1415 PANTHER LN
Practice Address - Street 2:SUITE 352
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-7874
Practice Address - Country:US
Practice Address - Phone:239-949-2300
Practice Address - Fax:239-597-0524
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6207101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health