Provider Demographics
NPI:1598061814
Name:ORTIZ-ARZUAGA, NOEMI (LMHC)
Entity Type:Individual
Prefix:
First Name:NOEMI
Middle Name:
Last Name:ORTIZ-ARZUAGA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:NOEMI
Other - Middle Name:ORTIZ
Other - Last Name:LYNN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:2621 CANYON FALLS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-4835
Mailing Address - Country:US
Mailing Address - Phone:904-992-7214
Mailing Address - Fax:
Practice Address - Street 1:8825 PERIMETER PARK BLVD STE 601
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1122
Practice Address - Country:US
Practice Address - Phone:904-705-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10367101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health