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General NPI Number Information
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NPI Number | 1518129832
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Entity Type | Organization
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Legal Business Name | NICOLE SCHWEON LMHC CAP NCC LLC
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Dates
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Enumeration Date | 06/27/2008
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 1003 3RD ST N
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-7238
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Country | US
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Telephone | 561-632-5567
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50518
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32240-0518
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | NICOLE SODERBERG
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Credential |
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Telephone | 561-632-5567
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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 | MH 8923
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License Number State | FL
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