Healthcare Provider Details

I. General information

NPI: 1831695360
Provider Name (Legal Business Name): JESSICA JAMES MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7465 SWALLOW RUN
WINTER PARK FL
32792-6536
US

IV. Provider business mailing address

3115 INNOVATION DR
SAINT CLOUD FL
34769-6501
US

V. Phone/Fax

Practice location:
  • Phone: 407-739-1050
  • Fax:
Mailing address:
  • Phone: 407-892-5700
  • Fax: 321-805-4156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH24130
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: