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General NPI Number Information
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NPI Number | 1730173444
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Entity Type | Organization
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Legal Business Name | THE COUNSELING GROUP, PA
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 664 CESERY BLVD SUITE 230
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City | JACKSONVILLE
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State | FL
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Zip | 32211-7147
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Country | US
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Telephone | 904-421-2119
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11729
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City | JACKSONVILLE
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State | FL
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Zip | 32239-1729
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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 | PRESIDENT
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Name | KURT SHONKA
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Credential |
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Telephone | 904-745-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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