Provider Demographics
NPI:1235205824
Name:DOWNEY, JILLAINE A (LMHC)
Entity Type:Individual
Prefix:
First Name:JILLAINE
Middle Name:A
Last Name:DOWNEY
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 1:8365 INNSBROOK DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-4242
Mailing Address - Country:US
Mailing Address - Phone:850-524-8232
Mailing Address - Fax:
Practice Address - Street 1:1000 W THARPE ST STE 14
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-5300
Practice Address - Country:US
Practice Address - Phone:850-561-0717
Practice Address - Fax:850-414-6876
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0001550101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH0001550OtherLICENSE NUMBER
FL763117100Medicaid