| Jem Therapy Services, Llc | |
|
1409 Kingsley Ave, Bldg 9, Suite D Orange Park FL 32073-4537 | |
| (904) 773-4665 | |
| (904) 773-4668 |
| Full Name | Jem Therapy Services, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1409 Kingsley Ave,, Orange Park, Florida |
| Authorized Official Name and Position | Jennifer Matilla (LICENSED MENTAL HEALTH COUNSELOR/QU) |
| Authorized Official Contact | 9047734665 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jem Therapy Services, Llc 1409 Kingsley Ave, Bldg 9, Suite D Orange Park FL 32073-4537 Ph: (904) 773-4665 | Jem Therapy Services, Llc 1409 Kingsley Ave, Bldg 9, Suite D Orange Park FL 32073-4537 Ph: (904) 773-4665 |
| NPI Number | 1558048405 |
|---|---|
| Provider Enumeration Date | 07/03/2023 |
| Last Update Date | 07/03/2023 |
| Certification Date | 07/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558048405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
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