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General NPI Number Information
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NPI Number | 1063183291
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Entity Type | Organization
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Legal Business Name | DUCKY BEHAVIORAL SOLUTIONS, INC
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Dates
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Enumeration Date | 09/27/2021
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 7260 LONGLEAF BRANCH DR
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City | JACKSONVILLE
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State | FL
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Zip | 32222-2199
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Country | US
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Telephone | 904-899-2160
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Fax |
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Provider Business Mailing Address
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Address Line | 9526 ARGYLE FOREST BLVD # B2142
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City | JACKSONVILLE
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State | FL
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Zip | 32222-2825
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Country | US
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Telephone | 904-899-2160
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDERSON JEROME SCHUYLER
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Credential | ED.D., LMHC
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Telephone | 904-887-5934
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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 |
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License Number State |
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