MEDICARE: JESSICA STRAUGHN

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	:	1285217109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA STRAUGHN

Provider Business Mailing Address
First Line	:	1451 LAKE FLORENCE WAY
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-8152
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1451 LAKE FLORENCE WAY
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-8152
Country	:	US
Telephone Number	:	407-906-5537
Fax Number	:	407-906-5537

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

Provider Enumeration Date	:	04/29/2021
Last Update Date	:	05/28/2023

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Directions to “ JESSICA STRAUGHN ” Practice Location

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