Doctor Name: | IRENE LISBETH LOGSDON |
NPI Number: | 1134197437 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 069963 |
Business Practice Address: | 111 W Main St Suite 305 Inverness, FL - 344504811 |
Business Phone Number: | 3524198983 |
Business Fax Number: | 3524198983 |
Mailing Address: | 111 W Main St, Suite 305 INVERNESS |
State: | FL |
Postal Code: | 344504811 |
Phone Number: | 3524198983 |
Fax Number: | 3524198983 |
NPI Enumeration Date: | 03/10/2006 |
NPI Last Update Date: | 12/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 069963 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |