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General NPI Number Information
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NPI Number | 1750766176
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA MENTAL HEALTH, LLC
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 1931 WELBY WAY STE 3
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City | TALLAHASSEE
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State | FL
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Zip | 32308
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Country | US
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Telephone | 850-219-0973
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Fax | 850-574-0513
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Provider Business Mailing Address
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Address Line | 1331 AIRPORT DRIVE G17
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City | TALLAHASSEE
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State | FL
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Zip | 32304-4775
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Country | US
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Telephone | 850-219-0973
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Fax | 850-574-0513
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Authorized Official
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Title or Position | CEO
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Name | HELEN ELIZABETH-MARIE STOREY
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Credential |
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Telephone | 850-219-0973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | MH11779
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MH11779
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | MH11779
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MH11779
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH11779
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License Number State | FL
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