Healthcare Provider Details

I. General information

NPI: 1578478186
Provider Name (Legal Business Name): STONEWAY BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

787 SWISS OAKS CT
ST JOHNS FL
32259-9095
US

IV. Provider business mailing address

787 SWISS OAKS CT
ST JOHNS FL
32259-9095
US

V. Phone/Fax

Practice location:
  • Phone: 904-588-2540
  • Fax:
Mailing address:
  • Phone: 904-588-2540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. NICHOLAS JOSEPH DEAN-ANDREWS
Title or Position: BCBA
Credential:
Phone: 904-588-2540