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General NPI Number Information
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NPI Number | 1427462472
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Entity Type | Individual
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Provider Name | JILLONNE LECOMPTE LMHC
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Gender | Female
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 5730 BOWDEN RD SUITE 206
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6104
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Country | US
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Telephone | 904-551-0760
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Fax | 904-745-3793
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Provider Business Mailing Address
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Address Line | 5730 BOWDEN RD SUITE 206
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6104
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Country | US
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Telephone | 904-525-4723
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Fax | 904-745-3973
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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 | MH5179
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License Number State | FL
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