Provider Demographics
NPI:1457119232
Name:JAMIE PRICE LMHC LLC
Entity type:Organization
Organization Name:JAMIE PRICE LMHC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:574-232-1309
Mailing Address - Street 1:210 S RACE ST
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46544-2032
Mailing Address - Country:US
Mailing Address - Phone:574-323-1309
Mailing Address - Fax:
Practice Address - Street 1:210 S RACE ST
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544-2032
Practice Address - Country:US
Practice Address - Phone:575-323-1309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty