Healthcare Provider Details

I. General information

NPI: 1528973740
Provider Name (Legal Business Name): FOUR OAKS COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 E 6TH AVE
TALLAHASSEE FL
32303-6208
US

IV. Provider business mailing address

3105 BRANDYWINE DR
TALLAHASSEE FL
32308-0501
US

V. Phone/Fax

Practice location:
  • Phone: 850-320-7490
  • Fax:
Mailing address:
  • Phone: 386-405-8557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY LEE BAGGS
Title or Position: CLINICAL DIRECTOR
Credential: LMHC
Phone: 850-320-7490