Organization
EMDR TRAUMA THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEANNIE L MITCHELL LMHC (PRINCIPLE/OWNER)
(904) 375-2353
Entity
Organization
Contact information
Practice address
4609 US HIGHWAY 17 STE 1, FLEMING ISLAND, FL 32003-4818
(904) 375-2353
(904) 375-2349
Mailing address
4609 US HIGHWAY 17 STE 1, FLEMING ISLAND, FL 32003-4818
(904) 375-2353
(904) 375-2349
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114348661
NPI
—
Enumeration date
07/10/2020
Last updated
01/26/2026
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