Healthcare Provider Details

I. General information

NPI: 1053100016
Provider Name (Legal Business Name): D B PATHS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10752 DEERWOOD PARK BLVD
JACKSONVILLE FL
32256-4849
US

IV. Provider business mailing address

3776 FENWICK ISLAND DR
JACKSONVILLE FL
32224-7963
US

V. Phone/Fax

Practice location:
  • Phone: 904-842-2461
  • Fax:
Mailing address:
  • Phone: 904-269-3522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: DORIS BENREY-BOGUSLAVSKY
Title or Position: OWNER
Credential: LMHC
Phone: 904-269-3522