Provider Demographics
NPI:1356009740
Name:WOMACK, NAOMI BROOKE (RCSWI)
Entity type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:BROOKE
Last Name:WOMACK
Suffix:
Gender:F
Credentials:RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6704 PLANTATION RD UNIT C
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-4207
Mailing Address - Country:US
Mailing Address - Phone:850-912-9774
Mailing Address - Fax:
Practice Address - Street 1:6704 PLANTATION RD UNIT C
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-4207
Practice Address - Country:US
Practice Address - Phone:850-760-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW153171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical