Provider Demographics
NPI:1730844192
Name:MOREJON, JENNIFER (LMFT)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:MOREJON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7755 W 30TH CT APT 110
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-3861
Mailing Address - Country:US
Mailing Address - Phone:786-516-6694
Mailing Address - Fax:
Practice Address - Street 1:7755 W 30TH CT APT 110
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-3861
Practice Address - Country:US
Practice Address - Phone:786-516-6694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3836101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMT3836Medicaid