Provider Demographics
NPI:1134189277
Name:WOLFINGER, JESSICA LYNN (LCSW)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LYNN
Last Name:WOLFINGER
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 1:5539 SASSPARILLA LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-7940
Mailing Address - Country:US
Mailing Address - Phone:407-666-9966
Mailing Address - Fax:
Practice Address - Street 1:206 PARK PLACE BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-2344
Practice Address - Country:US
Practice Address - Phone:407-666-9966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW117831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical