Provider Demographics
NPI:1679111934
Name:JONES, RENEE SLYVIA (MS, MHP)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:SLYVIA
Last Name:JONES
Suffix:
Gender:F
Credentials:MS, MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12147 ROCKFORD ST
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-2156
Mailing Address - Country:US
Mailing Address - Phone:216-704-2770
Mailing Address - Fax:
Practice Address - Street 1:5236 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1995
Practice Address - Country:US
Practice Address - Phone:216-704-2770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-18
Last Update Date:2024-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCMHP100040101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty