Healthcare Provider Details
I. General information
NPI: 1801954094
Provider Name (Legal Business Name): THE KADIE GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/04/2006
Last Update Date: 09/11/2025
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
- Phone: 904-687-1592
- Fax: 413-714-4590
- Phone: 904-687-1592
- Fax: 413-714-4590
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | MH0003697 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | MH5527 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PY6700 |
| License Number State | FL |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 000057-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
ALLEN
DROZD
Title or Position: DIRECTOR
Credential: LMHC, LPC, NCC
Phone: 904-687-1592