Provider Demographics
NPI:1780309500
Name:TELATYCKI, NANCY LEE ANNE (MSW)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:LEE ANNE
Last Name:TELATYCKI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:LEE ANNE
Other - Last Name:ELSWICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11269 SALOME ST
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34614-3424
Mailing Address - Country:US
Mailing Address - Phone:352-942-5966
Mailing Address - Fax:
Practice Address - Street 1:13515 LAKE TERRACE LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33637-1003
Practice Address - Country:US
Practice Address - Phone:813-998-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical