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General NPI Number Information
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NPI Number | 1265597405
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Entity Type | Individual
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Provider Name | EUGENE A USNER JR. LCSW
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 08/17/2016
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Provider Practice Location Address
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Address Line | 3082 3RD ST S
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-6033
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Country | US
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Telephone | 904-246-2629
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Fax | 904-246-1510
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Provider Business Mailing Address
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Address Line | 237 SAINT THOMAS ST
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32095-9606
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Country | US
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Telephone | 904-246-2629
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Fax | 904-246-1510
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW4231
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License Number State | FL
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