Healthcare Provider Details

I. General information

NPI: 1063805034
Provider Name (Legal Business Name): BOBBIE MASSEY-HOLLIFIELD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BOBBIE MASSEY

II. Dates (important events)

Enumeration Date: 03/14/2015
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4651 SALISBURY RD STE 400
JACKSONVILLE FL
32256-6187
US

IV. Provider business mailing address

9173 OLD CHEMONIE RD
TALLAHASSEE FL
32309-7432
US

V. Phone/Fax

Practice location:
  • Phone: 646-941-7645
  • Fax:
Mailing address:
  • Phone: 850-661-4685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 10728
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: