Individual provider · Type 1 NPI

Jacqueline Leigh (preferred) Mathis, REGISTERED INTERN

Mental Health Counselor · St. Augustine, FL

NPI number 1194512293 Active

Practice location

319 W Town Pl Ste 21
St. Augustine, FL 32092-3103

Call (904) 640-9099 Map

Mailing address

2872 N 1st St
St. Augustine, FL 32084-1942

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XMH27996 (FL)

Mental Health Counselor: Definition to come...

3 other providers at this address

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About NPI 1194512293

Jacqueline Leigh (preferred) Mathis, REGISTERED INTERN's National Provider Identifier is 1194512293, issued on Apr 22, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in St. Augustine, FL. The record was last updated on Jul 1, 2026.