| First Coast Mental Health, Pa | |
|
1543 Kingsley Ave Suite 6 Orange Park FL 32073-4535 | |
| (904) 269-7200 | |
| (904) 269-0070 |
| Full Name | First Coast Mental Health, Pa |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1543 Kingsley Ave, Orange Park, Florida |
| Authorized Official Name and Position | Marc Young (LICENSED MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 9042697200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| First Coast Mental Health, Pa 1543 Kingsley Ave Suite 6 Orange Park FL 32073 Ph: (904) 269-7200 | First Coast Mental Health, Pa 1543 Kingsley Ave Suite 6 Orange Park FL 32073-4535 Ph: (904) 269-7200 |
| NPI Number | 1134594195 |
|---|---|
| Provider Enumeration Date | 12/02/2015 |
| Last Update Date | 12/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134594195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH7277 (Florida) | Primary |
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