Healthcare Provider Details

I. General information

NPI: 1255117669
Provider Name (Legal Business Name): FREDERICK JOHN POST LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2023
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 S DIXIE HWY
SAINT AUGUSTINE FL
32084-0313
US

IV. Provider business mailing address

472 OCEAN JASPER DR
SAINT AUGUSTINE FL
32086-8090
US

V. Phone/Fax

Practice location:
  • Phone: 904-679-6630
  • Fax:
Mailing address:
  • Phone: 678-907-1705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH20587
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: