Provider Demographics
NPI:1205421740
Name:WILLIAMS MAINBERGER, JOANNE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:
Last Name:WILLIAMS MAINBERGER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:JOANNE
Other - Middle Name:M
Other - Last Name:ARCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4827 DUNN DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1432
Mailing Address - Country:US
Mailing Address - Phone:941-377-5377
Mailing Address - Fax:
Practice Address - Street 1:2863 8TH ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-3633
Practice Address - Country:US
Practice Address - Phone:941-361-6433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-06
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10353101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health