Healthcare Provider Details

I. General information

NPI: 1255250023
Provider Name (Legal Business Name): JENNIFER DAWN PRIOR RCMHCI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2830 NW 41ST ST STE J
GAINESVILLE FL
32606-6667
US

IV. Provider business mailing address

20852 NW 166TH PL
HIGH SPRINGS FL
32643-7779
US

V. Phone/Fax

Practice location:
  • Phone: 352-284-1024
  • Fax:
Mailing address:
  • Phone: 352-284-1024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH29523
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: