Provider Demographics
NPI:1871631994
Name:HOSICK, JERI (PHD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:JERI
Middle Name:
Last Name:HOSICK
Suffix:
Gender:F
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SANDPIPER AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2941
Mailing Address - Country:US
Mailing Address - Phone:561-795-6296
Mailing Address - Fax:561-792-0399
Practice Address - Street 1:1402 ROYAL PALM BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1691
Practice Address - Country:US
Practice Address - Phone:561-792-7755
Practice Address - Fax:561-792-0399
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 2784101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH-0002784OtherLIC.MENTALHEALTHCOUNSELOR