Provider Demographics
NPI:1619127016
Name:JONES, DESIREE CORLEY (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:DESIREE
Middle Name:CORLEY
Last Name:JONES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 140435
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32614-0435
Mailing Address - Country:US
Mailing Address - Phone:904-408-9288
Mailing Address - Fax:888-376-7135
Practice Address - Street 1:901 NW 8TH AVE STE B3-1
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-5011
Practice Address - Country:US
Practice Address - Phone:352-225-3710
Practice Address - Fax:888-376-7135
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8698101YM0800X
101YP2500X, 103K00000X, 104100000X, 171M00000X, 261QM0801X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023228500Medicaid
FL021665000Medicaid
FL016852900Medicaid
FL021961000Medicaid