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General NPI Number Information
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NPI Number | 1679080824
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Entity Type | Organization
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Legal Business Name | HEATHER M. FEWOX-STEEN, LMHC, LLC.
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Dates
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Enumeration Date | 01/09/2018
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Last Update Date | 01/09/2018
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Provider Practice Location Address
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Address Line | 3955 RIVERSIDE AVE STE 2F
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City | JACKSONVILLE
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State | FL
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Zip | 32205-3313
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Country | US
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Telephone | 904-434-2536
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Fax |
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Provider Business Mailing Address
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Address Line | 3955 RIVERSIDE AVE STE 2F
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City | JACKSONVILLE
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State | FL
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Zip | 32205-3313
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Country | US
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Telephone | 904-434-2536
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Fax |
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | MRS. HEATHER M FEWOX-STEEN
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Credential | LMHC
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Telephone | 904-434-2536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | MH10370
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License Number State | FL
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