Provider Demographics
NPI:1215188875
Name:JUNDT, JENNIFER HOLMES (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:HOLMES
Last Name:JUNDT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3492 BARNSTAPLE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-9062
Mailing Address - Country:US
Mailing Address - Phone:850-284-7017
Mailing Address - Fax:
Practice Address - Street 1:1113 S MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-4659
Practice Address - Country:US
Practice Address - Phone:850-284-7017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8835101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health