Healthcare Provider Details
I. General information
NPI: 1336013937
Provider Name (Legal Business Name): ZW JONES MENTAL HEALTH & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2025
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1046 E BRANDON BLVD STE 11
BRANDON FL
33511-5509
US
IV. Provider business mailing address
1046 E BRANDON BLVD STE 11
BRANDON FL
33511-5509
US
V. Phone/Fax
- Phone: 314-313-8029
- Fax: 813-435-2234
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ZW
JONES
JR.
Title or Position: PMHNP
Credential: PMHNP
Phone: 314-313-8029