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General NPI Number Information
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NPI Number | 1548315138
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Entity Type | Individual
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Provider Name | JANEAN FURDOCK LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 12/01/2016
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Provider Practice Location Address
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Address Line | 35114 STAGECOACH TRL
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City | EUSTIS
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State | FL
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Zip | 32736-8004
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Country | US
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Telephone | 321-377-2243
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Fax | 352-589-6738
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Provider Business Mailing Address
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Address Line | 35114 STAGECOACH TRL
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City | EUSTIS
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State | FL
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Zip | 32736-8004
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Country | US
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Telephone | 321-377-2243
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Fax | 352-589-6738
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW7776
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License Number State | FL
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