Provider Demographics
NPI:1972317501
Name:VINDELL, JACKELINE (MS, RMHCI)
Entity type:Individual
Prefix:
First Name:JACKELINE
Middle Name:
Last Name:VINDELL
Suffix:
Gender:F
Credentials:MS, RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 NORTH ANDREWS AVE
Mailing Address - Street 2:UNIT 102 #1191
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069
Mailing Address - Country:US
Mailing Address - Phone:954-682-1176
Mailing Address - Fax:
Practice Address - Street 1:2050 NORTH ANDREWS AVE
Practice Address - Street 2:UNIT 102 #1191
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069
Practice Address - Country:US
Practice Address - Phone:954-682-1176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH27237101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor