Provider Demographics
NPI:1538201975
Name:PRISCO, JO-ANN (LMHC)
Entity type:Individual
Prefix:MRS
First Name:JO-ANN
Middle Name:
Last Name:PRISCO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11368 SW GLENGARRY CT
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2812
Mailing Address - Country:US
Mailing Address - Phone:772-216-3031
Mailing Address - Fax:772-345-2837
Practice Address - Street 1:548 NW UNIVERSITY BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2284
Practice Address - Country:US
Practice Address - Phone:772-214-1010
Practice Address - Fax:772-345-2837
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5486101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013312900Medicaid
FL760558700Medicaid