Provider Information for 1144636424
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
JESSICA BURKEL-LAZIC LMHC
Sex: Female
NPI: 1144636424
Last Updated: 2024-03-07
Certification Date: 2024-03-07
Certification Date: 2024-03-07
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1144636424 | ||||||||
| Enumeration Date | 2014-07-07 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 748519 ATLANTA, GA 30374-8519 United States Phone: 904-376-3800 | Fax:904-376-3998 | ||||||||
| Primary Practice Address | 820 PRUDENTIAL DR STE 510 JACKSONVILLE, FL 32207-8207 United States Phone: 904-376-3800 | Fax:904-390-7398 | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|