| Authentic Self Counseling Of Jacksonville, Llc | |
|
3733 University Blvd W Ste 203 Jacksonville FL 32217-2152 | |
| (904) 990-7117 | |
| Not Available |
| Full Name | Authentic Self Counseling Of Jacksonville, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3733 University Blvd W Ste 203, Jacksonville, Florida |
| Authorized Official Name and Position | Michelle Anderson (OWNER) |
| Authorized Official Contact | 9049907117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Self Counseling Of Jacksonville, Llc 3733 University Blvd W Ste 203 Jacksonville FL 32217-2152 Ph: (904) 990-7117 | Authentic Self Counseling Of Jacksonville, Llc 3733 University Blvd W Ste 203 Jacksonville FL 32217-2152 Ph: (904) 990-7117 |
| NPI Number | 1407400591 |
|---|---|
| Provider Enumeration Date | 07/28/2019 |
| Last Update Date | 07/11/2022 |
| Certification Date | 07/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407400591 | NPI | - | NPPES |
| 1117302000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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