MEDICARE: MS. JESSIE S ANDERSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1053631143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JESSIE S ANDERSON

Provider Business Mailing Address
First Line	:	PO BOX 21926
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33416-1926
Country	:	US
Telephone Number	:	561-633-1986
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 W 10TH ST
Second Line	:
City	:	RIVIERA BEACH
State	:	FL
Zip	:	33404-6619
Country	:	US
Telephone Number	:	561-633-1986
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2010
Last Update Date	:	06/11/2010

Similar Medicare Providers

1376492850 — JOANNA STORM-LIU R.D.
Practice Location Address:

1531 PIPER DUNES PL
FERNANDINA BEACH, FL
32034-6619

Practice Phone: 610-888-9680
Practice Fax:

1578796611 — PEACEFUL SURROUNDINGS LLC
Practice Location Address:

332 DORSET AVE
VIRGINIA BEACH, VA
23462-6619

Practice Phone: 757-493-9302
Practice Fax:

1639570336 — KEVIN JONES DPT
Practice Location Address:

236 PONTE VEDRA PARK DR , SUITE 300
PONTE VEDRA BEACH, FL
32082-6619

Practice Phone: 904-280-3440
Practice Fax: 904-280-3444

1215339064 — FRANKIE SPARACIA DPT
Practice Location Address:

236 PONTE VEDRA PARK DR
PONTE VEDRA BEACH, FL
32082-6619

Practice Phone: 904-280-3440
Practice Fax: 904-280-3444

1871269696 — SOPHIE BARGERON DPT
Practice Location Address:

236 PONTE VEDRA PARK DR STE 300
PONTE VEDRA BEACH, FL
32082-6619

Practice Phone: 904-280-3440
Practice Fax:

1740985373 — MEGAN TAYLOR FORGACS
Practice Location Address:

236 PONTE VEDRA PARK DR STE 300
PONTE VEDRA BEACH, FL
32082-6619

Practice Phone: 904-280-3440
Practice Fax:

Directions to “ MS. JESSIE S ANDERSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.