Healthcare Provider Details

I. General information

NPI: 1851926216
Provider Name (Legal Business Name): JENNY BATALLA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2020
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 NumberMH21605
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH19157
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: