Healthcare Provider Details
I. General information
NPI: 1881289312
Provider Name (Legal Business Name): PERSPECTIVES COUNSELING OF NORTH EAST FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2021
Last Update Date: 03/05/2021
Certification Date: 03/05/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
596 CHESTWOOD CHASE DR
ORANGE PARK FL
32065-2571
US
IV. Provider business mailing address
596 CHESTWOOD CHASE DR
ORANGE PARK FL
32065-2571
US
V. Phone/Fax
- Phone: 904-945-7749
- Fax:
- Phone: 904-945-7749
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NATASHA
LAMB
Title or Position: OWNER
Credential: LCSW
Phone: 904-945-7749