Provider Demographics
NPI:1649300773
Name:HUME, JENNIFER JAMES (LPC, LMHC, CCADC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JAMES
Last Name:HUME
Suffix:
Gender:F
Credentials:LPC, LMHC, CCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6623 BREEZELOCH CT
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3731
Mailing Address - Country:US
Mailing Address - Phone:404-403-7559
Mailing Address - Fax:
Practice Address - Street 1:6623 BREEZELOCH CT
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3731
Practice Address - Country:US
Practice Address - Phone:404-403-7559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9917101YM0800X
GALPC003762101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional