Healthcare Provider Details
I. General information
NPI: 1093510422
Provider Name (Legal Business Name): AND THEN THERE IS YOU MENTAL HEALTH GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/18/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
266 PASEO REYES DR
ST AUGUSTINE FL
32095-8462
US
IV. Provider business mailing address
120 EVEREST LN STE 3
ST JOHNS FL
32259-4063
US
V. Phone/Fax
- Phone: 904-330-1306
- Fax: 603-386-6002
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARAH
BAUER
Title or Position: OWNER
Credential:
Phone: 732-275-7118