Healthcare Provider Details

I. General information

NPI: 1316823529
Provider Name (Legal Business Name): CENTER FOR RELATIONAL PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 MARKET ST
ST AUGUSTINE FL
32095-8800
US

IV. Provider business mailing address

701 MARKET ST
ST AUGUSTINE FL
32095-8800
US

V. Phone/Fax

Practice location:
  • Phone: 802-488-0497
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: AARON KINDSVATTER
Title or Position: OWNER
Credential:
Phone: 802-488-0497