Individual provider · Type 1 NPI
Fatisha Raynell Holness
Mental Health Counselor · Jacksonville, FL
NPI number
1730903360
Active
Practice location
4070 Herschel St Ste 11706
Jacksonville, FL 32210-2266
Mailing address
6645 S State Road 121
Macclenny, FL 32063-5439
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | IMH27455 (FL) |
Mental Health Counselor: Definition to come...
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About NPI 1730903360
Fatisha Raynell Holness's National Provider Identifier is 1730903360, issued on Nov 11, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Jacksonville, FL. The record was last updated on May 28, 2025.