MEDICARE: JOLENE HOLLINGSWORTH LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	SW9387	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063645414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOLENE HOLLINGSWORTH LCSW

Provider Business Mailing Address
First Line	:	7635 ASHLEY PARK CT
Second Line	:	SUITE 503-K
City	:	ORLANDO
State	:	FL
Zip	:	32835-6195
Country	:	US
Telephone Number	:	407-595-8530
Fax Number	:	407-296-2286

Provider Business Practice Location Address
First Line	:	7635 ASHLEY PARK CT
Second Line	:	SUITE 503-K
City	:	ORLANDO
State	:	FL
Zip	:	32835-6195
Country	:	US
Telephone Number	:	407-595-8530
Fax Number	:	407-296-2286

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2009
Last Update Date	:	06/03/2014

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