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General NPI Number Information
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NPI Number | 1588251599
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Entity Type | Organization
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Legal Business Name | ENITAN COUNSELING AND COACHING SERVICES
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Dates
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Enumeration Date | 12/23/2020
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 3100 UNIVERSITY BLVD S STE 218
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City | JACKSONVILLE
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State | FL
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Zip | 32216-2727
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Country | US
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Telephone | 904-834-9843
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Fax |
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Provider Business Mailing Address
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Address Line | 3100 UNIVERSITY BLVD S STE 218
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City | JACKSONVILLE
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State | FL
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Zip | 32216-2727
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Country | US
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Telephone | 904-834-9843
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIE VERNAL
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Credential | LCSW
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Telephone | 718-316-2899
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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 |
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License Number State |
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