| Southside Counselling Center Llc | |
|
3681 Carol Ann Ln Jacksonville FL 32223-7394 | |
| (904) 316-3365 | |
| (904) 292-2409 |
| Full Name | Southside Counselling Center Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3681 Carol Ann Ln, Jacksonville, Florida |
| Authorized Official Name and Position | Carmella Gardner (OWNER) |
| Authorized Official Contact | 9043163365 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Counselling Center Llc 2950 Halcyon Ln Jacksonville FL 32223-6689 Ph: (904) 316-3365 | Southside Counselling Center Llc 3681 Carol Ann Ln Jacksonville FL 32223-7394 Ph: (904) 316-3365 |
| NPI Number | 1124304167 |
|---|---|
| Provider Enumeration Date | 10/21/2011 |
| Last Update Date | 03/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124304167 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | MH8370 (Florida) | Primary |
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