MEDICARE: COMPREHENSIVE COUNSELING AND FAMILY SERVICES, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
4	261QM0850X	Adult Mental Health Clinic/Center
5	261QM0855X	Adolescent and Children Mental Health Clinic/Center
6	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1750863130
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE COUNSELING AND FAMILY SERVICES, LLC

Provider Business Mailing Address
First Line	:	6001ARGYLE FOREST BOULEVARD
Second Line	:	SUITE 21, PMB 272
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-6127
Country	:	US
Telephone Number	:	904-404-8113
Fax Number	:	904-453-8668

Provider Business Practice Location Address
First Line	:	3115 SPRING GLEN RD STE 504
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-5907
Country	:	US
Telephone Number	:	904-404-8113
Fax Number	:	904-453-8668

Authorized Official
Title or Position	:	CEO
Name	:	KENDRA DENITA SHEALEY
Credential	:	MA
Telephone Number	:	904-404-8113

Provider Enumeration Date	:	09/03/2018
Last Update Date	:	09/06/2024

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Directions to “COMPREHENSIVE COUNSELING AND FAMILY SERVICES, LLC ” Practice Location

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