Healthcare Provider Details

I. General information

NPI: 1720901796
Provider Name (Legal Business Name): LET IT SHINE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97524 ALBATROSS DRIVE
YULEE FL
32097
US

IV. Provider business mailing address

1445 SADLER RD STE 1001
FERNANDINA BEACH FL
32034-4434
US

V. Phone/Fax

Practice location:
  • Phone: 850-270-7166
  • Fax:
Mailing address:
  • Phone: 850-270-7166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ALANA WOODS
Title or Position: OWNER
Credential: LCSW
Phone: 850-737-6000