Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

James Derisse

Individual provider Mental Health Counselor · NPI 1780295170

James Derisse is a Mental Health Counselor in Jacksonville, Florida. Practices as a sole proprietor. Licensed in Florida and Texas.

Licensed in
FL, TX
In the registry since
2020
Specialties on file
2

Practice location Address checks out

2700 University Blvd W Bldg B
Jacksonville, FL 32217-2147
Phone: (904) 638-9767
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 22327 (FL)
Mental Health Counselor Taxonomy 101YM0800X · Licence 84360 (TX)

Record details

NPI number1780295170
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 11, 2020
Last updated in NPPESApril 25, 2024
Certification dateApril 25, 2024

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