Skip Navigation Link. Please press insert + down arrow if jaws does not start reading the content.

Provider Information for 1164059648


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

JEANNA FELICITA HOUSTON


Sex: Female

NPI: 1164059648
Last Updated: 2020-03-25
Certification Date: 2020-03-25

Details

NameValue
NPI1164059648
Enumeration Date2020-03-25
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 3810-3 WILLIAMSBURG PARK BLVD
JACKSONVILLE, FL 32257-9220
United States

Phone: 904-419-6102 | Fax:904-739-2153
 
Primary Practice Address 3810-3 WILLIAMSBURG PARK BLVD
JACKSONVILLE, FL 32257-9220
United States

Phone: 904-419-6102 | Fax:904-739-2153
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other URL
erika@breakthroughsIOP.com
PM email
Direct CSV 3810-3 Williamsburg Park Blvd
Jacksonville, FL 32257-9220
United States
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)FLmh16852MH license
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthFLmh16852