Provider Demographics
NPI:1194997395
Name:BANGSUND, JOELLE JUNE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:JOELLE
Middle Name:JUNE
Last Name:BANGSUND
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:JOELLE
Other - Middle Name:JUNE
Other - Last Name:MAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LICSW
Mailing Address - Street 1:835 OAKLEY SEAVER DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-1968
Mailing Address - Country:US
Mailing Address - Phone:352-241-9282
Mailing Address - Fax:352-241-4282
Practice Address - Street 1:835 OAKLEY SEAVER DR
Practice Address - Street 2:S
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1968
Practice Address - Country:US
Practice Address - Phone:352-241-9282
Practice Address - Fax:352-241-4282
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 66361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical