Provider Demographics
NPI:1942640131
Name:LOIACONO, JODIE MICHELE (LCSW)
Entity type:Individual
Prefix:
First Name:JODIE
Middle Name:MICHELE
Last Name:LOIACONO
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 1:1473 NW 111TH WAY
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6453
Mailing Address - Country:US
Mailing Address - Phone:954-254-4957
Mailing Address - Fax:
Practice Address - Street 1:1473 NW 111TH WAY
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6453
Practice Address - Country:US
Practice Address - Phone:954-254-4957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW140311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical