Healthcare Provider Details

I. General information

NPI: 1801668256
Provider Name (Legal Business Name): RIPPLE EFFECTS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2023
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2602 ISABELLA BLVD STE 10
JACKSONVILLE BEACH FL
32250-8000
US

IV. Provider business mailing address

1015 ATLANTIC BLVD # 103
ATLANTIC BEACH FL
32233-3313
US

V. Phone/Fax

Practice location:
  • Phone: 904-410-7144
  • Fax: 941-761-6353
Mailing address:
  • Phone: 904-410-7144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JENNY MICHELLE BATALLA
Title or Position: OWNER
Credential: LMHC
Phone: 904-410-7144