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General NPI Number Information
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NPI Number | 1326639592
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Entity Type | Individual
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Provider Name | KATHIE L LAND LMHC
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Gender | Female
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Dates
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Enumeration Date | 02/01/2021
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Last Update Date | 01/19/2025
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Provider Practice Location Address
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Address Line | 4693 SALISBURY RD RM 136
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6129
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Country | US
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Telephone | 727-358-4840
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Fax | 833-561-2501
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Provider Business Mailing Address
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Address Line | 382 NE 191ST ST PMB 776953
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City | MIAMI
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State | FL
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Zip | 33179-3899
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Country | US
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Telephone | 727-358-4840
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Fax | 833-561-2501
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH22625
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License Number State | FL
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