Provider Demographics
NPI:1952993859
Name:JAMIE LYNN DIMACCHIA LLC
Entity Type:Organization
Organization Name:JAMIE LYNN DIMACCHIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMACCHIA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:440-371-9084
Mailing Address - Street 1:323 FORREST CREST CT
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4009
Mailing Address - Country:US
Mailing Address - Phone:440-371-9084
Mailing Address - Fax:
Practice Address - Street 1:323 FORREST CREST CT
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4009
Practice Address - Country:US
Practice Address - Phone:440-371-9084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)