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General NPI Number Information
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NPI Number | 1023413101
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Entity Type | Organization
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Legal Business Name | NUVISION COUNSELING AND CONSULTING LLC
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Dates
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Enumeration Date | 10/30/2014
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Last Update Date | 10/30/2014
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Provider Practice Location Address
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Address Line | 9951 ATLANTIC BLVD SUITE 123
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City | JACKSONVILLE
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State | FL
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Zip | 32225-6584
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Country | US
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Telephone | 904-866-2248
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Fax |
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Provider Business Mailing Address
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Address Line | 9951 ATLANTIC BLVD SUITE 123
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City | JACKSONVILLE
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State | FL
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Zip | 32225-6584
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Country | US
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Telephone | 904-866-2248
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MISS TERRY SAMUELS
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Credential |
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Telephone | 904-866-2248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH11338
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License Number State | FL
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