MEDICARE: JEVEYNE CAINES LMHC

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	MH25529	FL

General Provider Information

NPI Number	:	1477105310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEVEYNE CAINES LMHC

Provider Business Mailing Address
First Line	:	373 FAIRFIELD DR
Second Line	:
City	:	SANFORD
State	:	FL
Zip	:	32771-6829
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6150 METROWEST BLVD STE 305
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-3291
Country	:	US
Telephone Number	:	407-512-8596
Fax Number	:

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

Provider Enumeration Date	:	07/11/2019
Last Update Date	:	04/11/2025

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