Provider Demographics
NPI:1962540377
Name:HAYS, JONTIE RENEE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JONTIE
Middle Name:RENEE
Last Name:HAYS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 A1A BEACH BLVD
Mailing Address - Street 2:STE 5
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-4728
Mailing Address - Country:US
Mailing Address - Phone:904-461-3313
Mailing Address - Fax:904-461-3312
Practice Address - Street 1:721 A1A BEACH BLVD
Practice Address - Street 2:STE 5
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-4728
Practice Address - Country:US
Practice Address - Phone:904-461-3313
Practice Address - Fax:904-461-3312
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00044701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical