Provider Demographics
NPI:1659840361
Name:VERMAAK, JESSICA MONIQUE (LMHC-QS, LPCC-S)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MONIQUE
Last Name:VERMAAK
Suffix:
Gender:F
Credentials:LMHC-QS, LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 SW CRANE CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2216
Mailing Address - Country:US
Mailing Address - Phone:561-350-6011
Mailing Address - Fax:
Practice Address - Street 1:1840 SW CRANE CREEK AVE
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2216
Practice Address - Country:US
Practice Address - Phone:561-350-6011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1800949-SUP101YM0800X
FLMH14675101YM0800X
OH83-1529261324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility