| NPI | 1417144031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOTT RICHELSON President, Treasurer, Secretary 904-605-4986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2022-12-30 |