| NPI | 1316480932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOTT RICHELSON President, Treasurer, Secretary 904-605-4986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YP2500X Counselor Professional | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TC0700X Psychologist Clinical | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2022-12-30 |