Healthcare Provider Details
I. General information
NPI: 1801762653
Provider Name (Legal Business Name): LORRIE JOURDEN COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/16/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4375 US HIGHWAY 17 STE 103
FLEMING ISLAND FL
32003-4832
US
IV. Provider business mailing address
12700 BARTRAM PARK BLVD APT 216
JACKSONVILLE FL
32258-5454
US
V. Phone/Fax
- Phone: 904-269-0886
- Fax: 904-269-0886
- Phone: 904-269-0886
- Fax: 904-269-0886
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LORRAINE
JO
JOURDEN
Title or Position: OWNER
Credential: LMHC
Phone: 512-431-4828