=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093510422
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AND THEN THERE IS YOU MENTAL HEALTH GROUP PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2025
-----------------------------------------------------
Last Update Date | 02/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 266 PASEO REYES DR
-----------------------------------------------------
City | ST AUGUSTINE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32095-8462
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-330-1306
-----------------------------------------------------
Fax | 603-386-6002
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 120 EVEREST LN STE 3
-----------------------------------------------------
City | ST JOHNS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32259-4063
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SARAH BAUER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 732-275-7118
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QM1300X
-----------------------------------------------------
Taxonomy Name | Multi-Specialty Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------