Provider Demographics
NPI:1831639368
Name:DIMACCHIA, JAMIE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:
Last Name:DIMACCHIA
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 1:323 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:
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1400197101YM0800X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health