Provider Demographics
NPI:1255789863
Name:DEMARK, JAMES (LMHC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:DEMARK
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1594 COMMON WAY RD APT 102
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6408
Mailing Address - Country:US
Mailing Address - Phone:407-399-1006
Mailing Address - Fax:
Practice Address - Street 1:1594 COMMON WAY RD APT 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6408
Practice Address - Country:US
Practice Address - Phone:407-399-1006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH1071101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health