Fatisha Raynell Holness

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH27455 Issued in FL

Practice address

4070 Herschel St Ste 11706
Jacksonville, FL 32210-2266

Phone

(904) 567-0813

NPI assigned

Nov 11, 2024

Last updated

May 28, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1730903360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6645 S STATE ROAD 121",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320635439",
            "telephone_number": "646-897-4317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 HERSCHEL ST STE 11706",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102266",
            "telephone_number": "904-567-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLNESS",
        "first_name": "FATISHA",
        "middle_name": "RAYNELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-11",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH27455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael James Holmes, IDC
• Nhora Holmes, ARNP
• Shatina Holmes
• Veronica M Holmes, NP
• Whitney Holmes
• Giselle Holness, A.R.N.P.
• Nancy Elizabeth Holsenbeck, APRN
• Lakeshia Holsey, ARNP
• Julia Holsomback, APRN
• Joyce M Holsopple, LMHC

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, 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 May 28, 2025; 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.