MEDICARE: JESSMARY ECHEVARRIA LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		FL
2	101YM0800X	Mental Health Counselor	18728	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790153054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSMARY ECHEVARRIA LMHC

Provider Business Mailing Address
First Line	:	1150 S SEMORAN BLVD STE A
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-1424
Country	:	US
Telephone Number	:	407-781-7049
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 S SEMORAN BLVD STE A
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-1424
Country	:	US
Telephone Number	:	407-704-7811
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2015
Last Update Date	:	10/08/2024

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