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General NPI Number Information
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NPI Number | 1881087724
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA FAMILY COUNSELING
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Dates
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Enumeration Date | 03/17/2015
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Last Update Date | 03/17/2015
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Provider Practice Location Address
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Address Line | 248 N MARION AVE
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City | LAKE CITY
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State | FL
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Zip | 32055-2804
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Country | US
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Telephone | 386-365-0885
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Fax |
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Provider Business Mailing Address
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Address Line | 248 N MARION AVE
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City | LAKE CITY
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State | FL
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Zip | 32055-2804
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Country | US
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Telephone | 386-365-0885
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Fax |
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Authorized Official
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Title or Position | OWNER, LIC. MENTAL HEALTH COUNSELOR
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Name | MRS. JANET BOGGS KUYKENDALL
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Credential | M.A., LMHC
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Telephone | 386-365-0885
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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 | MH 11653
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License Number State | FL
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