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General NPI Number Information
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NPI Number | 1124673249
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Entity Type | Organization
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Legal Business Name | FAMILY CONNECTIONS CONSULTANTS LLC
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Dates
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Enumeration Date | 08/06/2019
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | 685 CHARTER OAKS BLVD
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City | ORANGE PARK
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State | FL
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Zip | 32065-3211
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Country | US
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Telephone | 904-483-7875
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Fax |
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Provider Business Mailing Address
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Address Line | 225 COLLEGE DR UNIT 65503
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City | ORANGE PARK
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State | FL
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Zip | 32065-7821
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Country | US
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Telephone | 904-483-7875
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DEMETTA FRANCES VEREEN
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Credential | LMHC,NCC,CCMHC
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Telephone | 904-483-7875
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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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