Provider Demographics
NPI:1720332737
Name:CALVO, JOHANA (MA)
Entity type:Individual
Prefix:
First Name:JOHANA
Middle Name:
Last Name:CALVO
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8121 S WOODS CIR UNIT 10
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-6865
Mailing Address - Country:US
Mailing Address - Phone:786-294-7912
Mailing Address - Fax:
Practice Address - Street 1:3507 LEE BLVD STE 212
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1303
Practice Address - Country:US
Practice Address - Phone:239-888-0561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT3959106H00000X
FL0167079106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist