Provider Demographics
NPI:1447393368
Name:PLOCKELMAN, NANCY S (LCSW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:S
Last Name:PLOCKELMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 SW 13TH ST
Mailing Address - Street 2:ATTN BILLING & COLLECTIONS
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-4006
Mailing Address - Country:US
Mailing Address - Phone:352-374-5600
Mailing Address - Fax:352-375-0298
Practice Address - Street 1:4300 SW 13TH ST
Practice Address - Street 2:ATTN BILLING & COLLECTIONS
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-4006
Practice Address - Country:US
Practice Address - Phone:352-374-5600
Practice Address - Fax:352-375-0298
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW82471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical