MEDICARE: BEYOND THE MATTER COUNSELING AND CONSULTING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH12419	FL

General Provider Information

NPI Number	:	1700397890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEYOND THE MATTER COUNSELING AND CONSULTING SERVICES LLC

Provider Business Mailing Address
First Line	:	7362 BOYSENBERRY LN N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-5914
Country	:	US
Telephone Number	:	904-571-8413
Fax Number	:

Provider Business Practice Location Address
First Line	:	3955 RIVERSIDE AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32205-3312
Country	:	US
Telephone Number	:	904-549-6768
Fax Number	:	904-861-3815

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	MARIA G GIULIANA
Credential	:	MA, LMHC
Telephone Number	:	904-571-8413

Provider Enumeration Date	:	10/17/2017
Last Update Date	:	10/17/2017

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