Provider Demographics
NPI:1740692607
Name:JACQUES, HILARY (LMSW)
Entity type:Individual
Prefix:
First Name:HILARY
Middle Name:
Last Name:JACQUES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8895 N MILITARY TRAIL, STE 300C
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6279
Mailing Address - Country:US
Mailing Address - Phone:561-244-9499
Mailing Address - Fax:561-345-3800
Practice Address - Street 1:5205 GREENWOOD AVE STE 105
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2400
Practice Address - Country:US
Practice Address - Phone:561-244-9499
Practice Address - Fax:561-345-3800
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW8409101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103549600Medicaid