Provider Demographics
NPI:1922641059
Name:SETTJE, JACLYN SETTJE (LPC, LPC-MHSP, LMHC)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:SETTJE
Last Name:SETTJE
Suffix:
Gender:F
Credentials:LPC, LPC-MHSP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 10TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-4433
Mailing Address - Country:US
Mailing Address - Phone:901-277-8750
Mailing Address - Fax:
Practice Address - Street 1:1000 10TH ST SW
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-4433
Practice Address - Country:US
Practice Address - Phone:910-907-9854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3191101YM0800X
OK6347101YP2500X
FLMH86124101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional