Provider Demographics
NPI:1467956573
Name:DUTOIT, JAIMIE LEE (LPC-MHSP, LPC-S)
Entity Type:Individual
Prefix:
First Name:JAIMIE
Middle Name:LEE
Last Name:DUTOIT
Suffix:
Gender:F
Credentials:LPC-MHSP, LPC-S
Other - Prefix:
Other - First Name:JAIMIE
Other - Middle Name:LEE
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6858 SWINNEA RD BLDG 7
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-9493
Mailing Address - Country:US
Mailing Address - Phone:662-292-8204
Mailing Address - Fax:
Practice Address - Street 1:6858 SWINNEA RD BLDG 7
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-9493
Practice Address - Country:US
Practice Address - Phone:662-536-6210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-22
Last Update Date:2023-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4182101YP2500X
MS2596101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional