Provider Demographics
NPI:1821785999
Name:HONEYCUTT, JESSICA (MA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HONEYCUTT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 LOUISIANA AVE STE 214
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2350
Mailing Address - Country:US
Mailing Address - Phone:407-205-7760
Mailing Address - Fax:
Practice Address - Street 1:1133 LOUISIANA AVE STE 214
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2350
Practice Address - Country:US
Practice Address - Phone:407-205-7760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT3607106H00000X
FLIMH21437101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist