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General NPI Number Information
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NPI Number | 1003349945
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Entity Type | Individual
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Provider Name | KALIMA THEMA JACKSON WILLS LMHC
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Gender | Female
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 15615 HONEYBELL DR
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City | WINTER GARDEN
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State | FL
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Zip | 34787-5065
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Country | US
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Telephone | 407-986-1046
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Fax | 689-348-7003
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Provider Business Mailing Address
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Address Line | 2212 S CHICKASAW TRL STE 1069
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City | ORLANDO
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State | FL
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Zip | 32825-8414
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Country | US
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Telephone | 407-986-1046
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Fax | 689-348-7003
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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