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1912 Hamilton St Ste 108 Jacksonville FL 32210-2077 | |
| (904) 419-9864 | |
| (904) 212-0929 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1912 Hamilton St Ste 108, Jacksonville, Florida |
| Authorized Official Name and Position | Allison Dempsey (CEO) |
| Authorized Official Contact | 9044199864 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4530 Saint Johns Ave Ste 15-214 Jacksonville FL 32210-1852 Ph: (904) 419-9864 | 1912 Hamilton St Ste 108 Jacksonville FL 32210-2077 Ph: (904) 419-9864 |
| NPI Number | 1346996477 |
|---|---|
| Provider Enumeration Date | 02/28/2022 |
| Last Update Date | 06/20/2022 |
| Certification Date | 06/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346996477 | NPI | - | NPPES |
| 018152000 | Medicaid | FL |
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