Provider Demographics
NPI:1962064980
Name:JARMULOWICZ, ANIA E (LCSW)
Entity type:Individual
Prefix:
First Name:ANIA
Middle Name:E
Last Name:JARMULOWICZ
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 1:8704 PERSEA CT
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5332
Mailing Address - Country:US
Mailing Address - Phone:727-358-6426
Mailing Address - Fax:
Practice Address - Street 1:8704 PERSEA CT
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-5332
Practice Address - Country:US
Practice Address - Phone:727-358-6426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-29
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL059528001041C0700X
FLSW179551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW17955OtherFLORIDA DEPARTMENT OF HEALTH, DIVISION OF MEDICAL QUALITY ASSURANCE
FLL21000534523OtherTHE DIVISION OF CORPORATIONS IS THE STATE OF FLORIDA
NJ44SC06059100OtherSOCIAL WORK EXAMINERS