Healthcare Provider Details

I. General information

NPI: 1679947352
Provider Name (Legal Business Name): GINGER E. WOODS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2015
Last Update Date: 01/07/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5868 CREEK STATION DR BLDG A
PENSACOLA FL
32504-8627
US

IV. Provider business mailing address

2315 W JACKSON ST
PENSACOLA FL
32505-7552
US

V. Phone/Fax

Practice location:
  • Phone: 850-478-1244
  • Fax: 850-478-1894
Mailing address:
  • Phone: 850-436-4630
  • Fax: 850-436-2095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 12544
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: