Provider Demographics
NPI:1871626648
Name:PECUCH, JOANNE (LCSW, PSYD)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:PECUCH
Suffix:
Gender:F
Credentials:LCSW, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6503 NW 66TH WAY
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-1415
Mailing Address - Country:US
Mailing Address - Phone:305-807-1313
Mailing Address - Fax:
Practice Address - Street 1:6810 N STATE ROAD 7 STE 124
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4304
Practice Address - Country:US
Practice Address - Phone:305-807-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW85681041C0700X
FLPY7759103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical