Provider Demographics
NPI:1285054213
Name:RAYMOND, JENNIFER MARIE (LMHC, NCC,QS)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:LMHC, NCC,QS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 FITCH DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-3706
Mailing Address - Country:US
Mailing Address - Phone:561-577-2217
Mailing Address - Fax:
Practice Address - Street 1:981 FITCH DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-3706
Practice Address - Country:US
Practice Address - Phone:561-577-2217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101YM0800XMedicaid