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General NPI Number Information
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NPI Number | 1871909226
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Entity Type | Organization
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Legal Business Name | PUZZLE PEACE COUNSELING, LLC
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Dates
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Enumeration Date | 07/07/2014
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Last Update Date | 07/07/2014
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Provider Practice Location Address
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Address Line | 5270 PALM VALLEY RD
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City | PONTE VEDRA
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State | FL
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Zip | 32082-3200
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Country | US
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Telephone | 904-501-3809
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Fax |
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Provider Business Mailing Address
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Address Line | 5270 PALM VALLEY RD
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City | PONTE VEDRA
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State | FL
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Zip | 32082-3200
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Country | US
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Telephone | 904-501-3809
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MS. JANEEN M HERSKOVITZ
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Credential | MA, LMHC
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Telephone | 904-501-3809
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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 | MH12319
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License Number State | FL
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