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General NPI Number Information
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NPI Number | 1255245023
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Entity Type | Organization
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Legal Business Name | COUNSELING CENTERS OF AMERICA LLC
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 5874 SANDSTONE WAY
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5417
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Country | US
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Telephone | 833-825-5588
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Fax |
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Provider Business Mailing Address
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Address Line | 1604 FENTON AVE
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City | SAINT JOHNS
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State | FL
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Zip | 32259-7288
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Country | US
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Telephone | 833-825-5588
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | SABRINA AHMED
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Credential | LMHC
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Telephone | 833-825-5588
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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 | NULL
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