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NPI Code Detail

MEDICARE: JEANETTE DE JESUS LMHC

MEDICARE: JEANETTE DE JESUS 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
1101YM0800XMental Health CounselorMH26873FL

General Provider Information

NPI Number : 1598251514
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANETTE DE JESUS LMHC
Provider Business Mailing Address
First Line : 3291 DELLBROOK DR
Second Line :
City : DELTONA
State : FL
Zip : 32738-5469
Country : US
Telephone Number : 407-218-1833
Fax Number :
Provider Business Practice Location Address
First Line : 565 MEMORIAL CIR
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-5001
Country : US
Telephone Number : 386-310-8766
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2018
Last Update Date : 03/02/2026

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