Provider Demographics
NPI:1972044584
Name:O'DONNELL, MARIA ANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ANNE
Last Name:O'DONNELL
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 1:48 JARDIN DE MER PL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32250-8611
Mailing Address - Country:US
Mailing Address - Phone:904-982-4727
Mailing Address - Fax:
Practice Address - Street 1:48 JARDIN DE MER PL
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32250-8611
Practice Address - Country:US
Practice Address - Phone:904-982-4727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-15
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL197761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical