Healthcare Provider Details

I. General information

NPI: 1205750916
Provider Name (Legal Business Name): JENNYSHA KIARA RAINEY RCSWI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13009 SPRING HILL DR
SPRING HILL FL
34609-5048
US

IV. Provider business mailing address

4032 PORTILLO RD
SPRING HILL FL
34608-7209
US

V. Phone/Fax

Practice location:
  • Phone: 727-379-4324
  • Fax:
Mailing address:
  • Phone: 727-505-6367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberISW23461
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: