Angela Jerry
Counselor, Mental Health in Orlando, FL. Individual provider (NPI-1).
NPI number1124454855
StatusActive
Last updated in NPPESJan 4, 2017
Details
- NPI
- 1124454855
- Entity type
- Individual (NPI-1)
- Name
- Angela Jerry
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 26, 2013
- Last updated
- Jan 4, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | IMH11740 | FL | Yes |
| 101YM0800X | Counselor, Mental Health | 11740 | FL |
Practice location
4700 Millenia BlvdSuite 175
Orlando, FL 32839-6013
Phone 407-801-8476
Mailing address
10069 Lee Vista BlvdApartment 11108
Orlando, FL 32829-8117
Phone 813-444-2784
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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