Provider Demographics
NPI:1437515046
Name:JAMIE H. KOPP
Entity Type:Organization
Organization Name:JAMIE H. KOPP
Other - Org Name:KOPP'S COUNSELING AND CONSULTING SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:HOLDMAN
Authorized Official - Last Name:KOPP
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:904-891-2576
Mailing Address - Street 1:10010 SKINNER LAKE DR
Mailing Address - Street 2:UNIT 922
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-8408
Mailing Address - Country:US
Mailing Address - Phone:904-891-2576
Mailing Address - Fax:904-743-9289
Practice Address - Street 1:8825 PERIMETER PARK BLVD
Practice Address - Street 2:SUITE 601
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1108
Practice Address - Country:US
Practice Address - Phone:904-891-2576
Practice Address - Fax:904-743-9289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty