MRS. RENEE GARCIA WYDEN LCSW NPI 1164416889

NPI Information

NPI: 1164416889
Provider Name: MRS. RENEE GARCIA WYDEN, LCSW
Classification: Counselor - 101Y00000X
Entity Type: Individual
Address:
2950 HALCYON LN
SUITE 703
JACKSONVILLE, FL
ZIP 32223
Phone: (904) 638-7042
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MRS. Renee Garcia Wyden, LCSW is a counselor in Jacksonville, FL. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. MRS. Renee Garcia Wyden, LCSW NPI is 1164416889. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2950 HALCYON LN
SUITE 703
JACKSONVILLE, FL
ZIP 32223-689
Phone: (904) 638-7042

The enumeration date for this NPI number is 9/8/2005 and was last updated on 4/6/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor		SW6557	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	29717	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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