Provider Demographics
NPI:1255760112
Name:PIERCY, JEFFREY (MS, LMHC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:PIERCY
Suffix:
Gender:
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1637 RACE TRACK RD
Mailing Address - Street 2:SUITE 236
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-3239
Mailing Address - Country:US
Mailing Address - Phone:904-716-3828
Mailing Address - Fax:
Practice Address - Street 1:1637 RACE TRACK RD
Practice Address - Street 2:SUITE 236
Practice Address - City:SAINT JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-3239
Practice Address - Country:US
Practice Address - Phone:904-716-3828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12106101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health