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NPI Code Detail

MEDICARE: CHRISTINE GOTTSCHALK

MEDICARE: CHRISTINE GOTTSCHALK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor30-0290517FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427590934
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE GOTTSCHALK
Provider Business Mailing Address
First Line : 1358 HOLLYHOCK CIR W
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-5220
Country : US
Telephone Number : 904-445-1286
Fax Number :
Provider Business Practice Location Address
First Line : 1419 UNIVERSITY BLVD N
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-5249
Country : US
Telephone Number : 904-745-0067
Fax Number : 904-745-1030
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2016
Last Update Date : 11/15/2016

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Directions to “ CHRISTINE GOTTSCHALK ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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