Provider Demographics
NPI:1184265019
Name:DEJEAN, GISELLE (LCSW AND LICSW)
Entity type:Individual
Prefix:
First Name:GISELLE
Middle Name:
Last Name:DEJEAN
Suffix:
Gender:F
Credentials:LCSW AND LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:887 GAZEBO CIR APT 6106
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-5239
Mailing Address - Country:US
Mailing Address - Phone:407-431-0425
Mailing Address - Fax:
Practice Address - Street 1:887 GAZEBO CIR APT 6106
Practice Address - Street 2:
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-5239
Practice Address - Country:US
Practice Address - Phone:407-431-0425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW235261041C0700X
MALICSW11208771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical