| Southside Counseling Biofeedback & Stress Management Center, Inc | |
|
4943 Beach Blvd Jacksonville FL 32207-4802 | |
| (904) 396-9144 | |
| Not Available |
| Full Name | Southside Counseling Biofeedback & Stress Management Center, Inc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4943 Beach Blvd, Jacksonville, Florida |
| Authorized Official Name and Position | Theresa G. Stanford (CHIEF EXECUTIVE) |
| Authorized Official Contact | 9043969144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Counseling Biofeedback & Stress Management Center, Inc 4943 Beach Blvd Jacksonville FL 32207-4802 Ph: (904) 396-9144 | Southside Counseling Biofeedback & Stress Management Center, Inc 4943 Beach Blvd Jacksonville FL 32207-4802 Ph: (904) 396-9144 |
| NPI Number | 1760932529 |
|---|---|
| Provider Enumeration Date | 10/05/2016 |
| Last Update Date | 10/05/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760932529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH 1539 (Florida) | Primary |
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