Provider Demographics
NPI:1376025320
Name:CHAMBERS, JAYME LEIGH (LMHC)
Entity Type:Individual
Prefix:
First Name:JAYME
Middle Name:LEIGH
Last Name:CHAMBERS
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 1:12123 LEDBURY COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONTON
Mailing Address - State:FL
Mailing Address - Zip Code:33534-3026
Mailing Address - Country:US
Mailing Address - Phone:813-505-2662
Mailing Address - Fax:
Practice Address - Street 1:300 FRANDORSON CIR STE 200
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-2690
Practice Address - Country:US
Practice Address - Phone:813-296-7911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15736101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health