| J-nissi's Therapy & Counseling Llc | |
|
1536 Kingsley Ave Ste 120 Orange Park FL 32073-4525 | |
| (904) 304-3800 | |
| (904) 644-7123 |
| Full Name | J-nissi's Therapy & Counseling Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1536 Kingsley Ave Ste 120, Orange Park, Florida |
| Authorized Official Name and Position | Renee Anita Dunham (OWNER) |
| Authorized Official Contact | 9033043800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J-nissi's Therapy & Counseling Llc 1536 Kingsley Ave Ste 120 Orange Park FL 32073-4525 Ph: (904) 304-3800 | J-nissi's Therapy & Counseling Llc 1536 Kingsley Ave Ste 120 Orange Park FL 32073-4525 Ph: (904) 304-3800 |
| NPI Number | 1558890392 |
|---|---|
| Provider Enumeration Date | 06/06/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558890392 | NPI | - | NPPES |
| MH11462 | Other | FL | FLORIDA DEPARTMENT HEALTH |
| 007347100 | Medicaid | FL | |
| 5901 | Other | FL | FLORIDA CERTIFICATION BOARD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH11462 (Florida) | Primary |
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