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General NPI Number Information
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NPI Number | 1346098274
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Entity Type | Individual
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Provider Name | LORRAINE JO JOURDEN LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/07/2024
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 4375 US HIGHWAY 17 STE 103
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-4832
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Country | US
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Telephone | 904-269-0886
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Fax | 904-269-0886
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Provider Business Mailing Address
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Address Line | 12700 BARTRAM PARK BLVD APT 216
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5454
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Country | US
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Telephone | 512-431-4828
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Fax |
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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 | MH23558
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License Number State | FL
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