Provider Demographics
NPI:1700179728
Name:ALESKI, JEANMARIE (MSW)
Entity type:Individual
Prefix:MS
First Name:JEANMARIE
Middle Name:
Last Name:ALESKI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JEANMARIE
Other - Middle Name:
Other - Last Name:ALESKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-424-1400
Mailing Address - Fax:239-424-1421
Practice Address - Street 1:12550 NEW BRITTANY BLVD
Practice Address - Street 2:# 200
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3655
Practice Address - Country:US
Practice Address - Phone:239-936-1114
Practice Address - Fax:239-343-9188
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
FLSW117511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker