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Organization
J-NISSI'S THERAPY & COUNSELING LLC
Active
Organization
J-NISSI'S THERAPY & COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RENEE ANITA DUNHAM LMHC (OWNER)
(903) 304-3800
Entity
Organization
Contact information
Practice address
1536 KINGSLEY AVE STE 120, ORANGE PARK, FL 32073-4525
(904) 304-3800
(904) 644-7123
Mailing address
1536 KINGSLEY AVE STE 120, ORANGE PARK, FL 32073-4525
(904) 304-3800
(904) 644-7123
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH11462
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007347100
—
FL
01
—
5901
FLORIDA CERTIFICATION BOARD
FL
01
—
MH11462
FLORIDA DEPARTMENT HEALTH
FL
Enumeration date
06/06/2017
Last updated
07/21/2022
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