Provider Demographics
NPI:1962447433
Name:D'ONOFRIO, JEANINE (LMHC, NCC)
Entity Type:Individual
Prefix:MISS
First Name:JEANINE
Middle Name:
Last Name:D'ONOFRIO
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 E ROSEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-4821
Mailing Address - Country:US
Mailing Address - Phone:352-408-7723
Mailing Address - Fax:352-742-8305
Practice Address - Street 1:1799 SALK AVE
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-4311
Practice Address - Country:US
Practice Address - Phone:352-742-8300
Practice Address - Fax:352-742-8305
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7463101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health