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General NPI Number Information
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NPI Number | 1184357923
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Entity Type | Organization
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Legal Business Name | EMBRACING BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 07/08/2022
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 12724 GRAN BAY PKWY W STE 410
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City | JACKSONVILLE
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State | FL
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Zip | 32258-9486
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Country | US
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Telephone | 904-465-2407
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Fax |
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Provider Business Mailing Address
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Address Line | 12724 GRAN BAY PKWY W STE 410
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City | JACKSONVILLE
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State | FL
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Zip | 32258-9486
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Country | US
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Telephone | 904-710-8636
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Fax |
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Authorized Official
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Title or Position | MANAGER/PMHNP
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Name | CAROLYN ANN MCCLINTON
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Credential | DNP PMHNP-BC, FNP-C
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Telephone | 904-710-8636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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