Healthcare Provider Details

I. General information

NPI: 1508831132
Provider Name (Legal Business Name): JACQUELINE ADAMSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7208 W SAND LAKE RD STE 305
ORLANDO FL
32819-5279
US

IV. Provider business mailing address

7208 W SAND LAKE RD STE 305
ORLANDO FL
32819-5279
US

V. Phone/Fax

Practice location:
  • Phone: 904-910-7311
  • Fax:
Mailing address:
  • Phone: 904-910-7311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2599
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number831
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: