Healthcare Provider Details

I. General information

NPI: 1699908186
Provider Name (Legal Business Name): ALLEN DROZD LMHC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 08/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 CATHEDRAL PL SUITE 400
ST AUGUSTINE FL
32084-4473
US

IV. Provider business mailing address

303B ANASTASIA BLVD #159
ST AUGUSTINE FL
32080-4506
US

V. Phone/Fax

Practice location:
  • Phone: 904-687-1592
  • Fax: 866-902-0819
Mailing address:
  • Phone: 904-687-1592
  • Fax: 866-902-0819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH0003697
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: