J-Nissi's Therapy & Counseling LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH11462 Issued in FL

Legal business name

J-NISSI'S THERAPY & COUNSELING LLC

Practice address

1536 Kingsley Ave Ste 120
Orange Park, FL 32073-4525

Phone

(904) 304-3800

Fax

(904) 644-7123

NPI assigned

Jun 6, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Renee Anita Dunham, LMHC

Title

Owner

Phone

(903) 304-3800

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1558890392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 KINGSLEY AVE STE 120",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734525",
            "telephone_number": "904-304-3800",
            "fax_number": "904-644-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 KINGSLEY AVE STE 120",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734525",
            "telephone_number": "904-304-3800",
            "fax_number": "904-644-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J-NISSI'S THERAPY & COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DUNHAM",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "ANITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-304-3800",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT HEALTH",
            "identifier": "MH11462",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007347100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA CERTIFICATION BOARD",
            "identifier": "5901",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.