Healthcare Provider Details

I. General information

NPI: 1467360594
Provider Name (Legal Business Name): JAY ORTIZ COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 MAHAFFEY CIR
LAKELAND FL
33811-4458
US

IV. Provider business mailing address

1855 MAHAFFEY CIR
LAKELAND FL
33811-4458
US

V. Phone/Fax

Practice location:
  • Phone: 813-786-6297
  • Fax: 888-796-5563
Mailing address:
  • Phone: 813-786-6297
  • Fax: 888-796-5563

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: JAY ORTIZ
Title or Position: OWNER/CLINICIAN
Credential: MS, LMHC
Phone: 813-786-6297