Provider Demographics
NPI:1528250511
Name:FLYNN, RONI (PSYD, LMHC)
Entity type:Individual
Prefix:DR
First Name:RONI
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:PSYD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BEACH DR SE
Mailing Address - Street 2:2612
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3963
Mailing Address - Country:US
Mailing Address - Phone:727-656-1799
Mailing Address - Fax:
Practice Address - Street 1:12708 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2802
Practice Address - Country:US
Practice Address - Phone:727-656-1799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0003046101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health