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General NPI Number Information
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NPI Number | 1437515046
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Entity Type | Organization
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Legal Business Name | JAMIE H. KOPP
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Dates
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Enumeration Date | 01/12/2016
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Last Update Date | 01/12/2016
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Provider Practice Location Address
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Address Line | 8825 PERIMETER PARK BLVD SUITE 601
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City | JACKSONVILLE
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State | FL
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Zip | 32216-1108
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Country | US
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Telephone | 904-891-2576
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Fax | 904-743-9289
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Provider Business Mailing Address
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Address Line | 10010 SKINNER LAKE DR UNIT 922
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City | JACKSONVILLE
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State | FL
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Zip | 32246-8408
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Country | US
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Telephone | 904-891-2576
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Fax | 904-743-9289
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | MS. JAMIE HOLDMAN KOPP
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Credential | LMHC
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Telephone | 904-891-2576
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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 | FL
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