Provider Demographics
NPI:1568755742
Name:KOPP, JAMIE HOLDMAN (LMHC)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:HOLDMAN
Last Name:KOPP
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6940 ROUNDLEAF DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5505
Mailing Address - Country:US
Mailing Address - Phone:904-923-3605
Mailing Address - Fax:904-431-3542
Practice Address - Street 1:6940 ROUNDLEAF DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-5505
Practice Address - Country:US
Practice Address - Phone:904-923-3605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-22
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10753101YM0800X
FLMH 10753101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health