Provider Demographics
NPI:1922797703
Name:MEREDITH, JACQUELINE A (LMHC)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:A
Last Name:MEREDITH
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 1:225 W CANTON AVENUE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-3181
Mailing Address - Country:US
Mailing Address - Phone:407-347-4536
Mailing Address - Fax:812-285-8392
Practice Address - Street 1:225 W. CANTON AVENUE
Practice Address - Street 2:SUITE 600
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3181
Practice Address - Country:US
Practice Address - Phone:407-347-4536
Practice Address - Fax:812-285-8392
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15366101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health