Provider Demographics
NPI:1568755742
Name:KOPP, JAMIE HOLDMAN (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:HOLDMAN
Last Name:KOPP
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Gender:F
Credentials:LMHC
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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
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-22
Last Update Date:2016-01-12
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Provider Licenses
StateLicense IDTaxonomies
FLMH 10753101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health