Provider Demographics
NPI:1316358229
Name:FLORES, JAIME LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:LYNN
Last Name:FLORES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 RIGGS RD
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28555-9692
Mailing Address - Country:US
Mailing Address - Phone:760-782-7935
Mailing Address - Fax:
Practice Address - Street 1:2457 GUM BRANCH RD STE 800
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-4008
Practice Address - Country:US
Practice Address - Phone:910-238-2774
Practice Address - Fax:910-387-0757
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0125091041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical