Provider Demographics
NPI:1851926216
Name:BATALLA, JENNY (LMHC)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:BATALLA
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 1:1015 ATLANTIC BLVD # 103
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32233-3313
Mailing Address - Country:US
Mailing Address - Phone:904-780-0207
Mailing Address - Fax:
Practice Address - Street 1:4400 MARSH LANDING BLVD STE 203
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-1287
Practice Address - Country:US
Practice Address - Phone:904-780-0207
Practice Address - Fax:941-761-6353
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH19157101YM0800X
FLMH21605101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health