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General NPI Number Information
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NPI Number | 1427467588
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Entity Type | Organization
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Legal Business Name | SUCCESS POINT, P.A.
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Dates
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Enumeration Date | 08/03/2014
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Last Update Date | 08/03/2014
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Provider Practice Location Address
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Address Line | 1816 UNIVERSITY BLVD W
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2012
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Country | US
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Telephone | 904-672-6185
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Fax |
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Provider Business Mailing Address
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Address Line | 1816 UNIVERSITY BLVD W
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2012
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Country | US
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Telephone | 904-672-6185
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JEFFREY ENGELSKIRCH
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Credential | M.ED., LMHC
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Telephone | 904-672-6185
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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 | MH9636
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | MH9636
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MH9636
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License Number State | FL
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