Provider Demographics
NPI:1639853229
Name:SPIKES, JONATHAN (DSW, LMHC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:SPIKES
Suffix:
Gender:M
Credentials:DSW, 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 380861
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33238-0861
Mailing Address - Country:US
Mailing Address - Phone:305-230-4598
Mailing Address - Fax:305-230-4626
Practice Address - Street 1:150 NW 79TH ST STE 342
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-3016
Practice Address - Country:US
Practice Address - Phone:305-230-4598
Practice Address - Fax:305-230-4626
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21714101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health