Provider Demographics
NPI:1831952431
Name:JAYMES, JACINDA (LPCC, LMHC)
Entity type:Individual
Prefix:MRS
First Name:JACINDA
Middle Name:
Last Name:JAYMES
Suffix:
Gender:F
Credentials:LPCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 E 150 S
Mailing Address - Street 2:
Mailing Address - City:BRINGHURST
Mailing Address - State:IN
Mailing Address - Zip Code:46913-9636
Mailing Address - Country:US
Mailing Address - Phone:513-646-1479
Mailing Address - Fax:
Practice Address - Street 1:9200 MONTGOMERY RD BLDG D
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-7789
Practice Address - Country:US
Practice Address - Phone:513-600-2554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003767A101YM0800X
OHE.1901487101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health