Individual
JO CISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
3292 COUNTY ROAD 220, MIDDLEBURG, FL 32068-4357
(904) 291-5561
(904) 278-5659
Mailing address
1726 KINGSLEY AVE STE 2, ORANGE PARK, FL 32073-4411
(904) 278-5644
(904) 278-5659
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH5101
FL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z9156
BLUECROSS
FL
Enumeration date
01/09/2007
Last updated
09/11/2025
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