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General NPI Number Information
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NPI Number | 1871968792
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Entity Type | Organization
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Legal Business Name | SUSAN CARDIFF-REED, LCSW
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Dates
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Enumeration Date | 12/03/2015
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 2692 US 1 S SUITE 110
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-4903
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Country | US
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Telephone | 904-671-5726
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Fax | 904-239-5522
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Provider Business Mailing Address
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Address Line | 2692 US1 SOUTH SUITE 110
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City | ST. AUGUSTINE
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State | FL
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Zip | 32086-4909
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Country | US
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Telephone | 904-671-5726
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Fax | 904-239-5522
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | SUSAN PATRICIA CARDIFF-REED
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Credential | LCSW
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Telephone | 904-671-5726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | SW6980
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License Number State | FL
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