Provider Demographics
NPI:1265171748
Name:DIPIERRO, BOBBIE JO (LMHC)
Entity type:Individual
Prefix:
First Name:BOBBIE JO
Middle Name:
Last Name:DIPIERRO
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 1:4609 US HIGHWAY 17 STE 1
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-4818
Mailing Address - Country:US
Mailing Address - Phone:904-375-2353
Mailing Address - Fax:904-375-2349
Practice Address - Street 1:4609 US HIGHWAY 17 STE 1
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-4818
Practice Address - Country:US
Practice Address - Phone:904-375-2353
Practice Address - Fax:904-375-2349
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health