Provider Demographics
NPI:1033902739
Name:JACQUELINE MEREDITH LMHC LLC
Entity type:Organization
Organization Name:JACQUELINE MEREDITH LMHC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:MEREDITH LMHC
Authorized Official - Last Name:LLC
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:904-307-5906
Mailing Address - Street 1:2 DONDANVILLE RD UNIT 315
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-7406
Mailing Address - Country:US
Mailing Address - Phone:904-307-5906
Mailing Address - Fax:
Practice Address - Street 1:2 DONDANVILLE RD UNIT 315
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-7406
Practice Address - Country:US
Practice Address - Phone:904-307-5906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty