MEDICARE: SHREDERS & ASSOCIATES, INC.

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
1	101YM0800X	Mental Health Counselor	MH 10130	FL

General Provider Information

NPI Number	:	1801263108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHREDERS & ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	12058 SAN JOSE BLVD
Second Line	:	SUITE 104
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-8669
Country	:	US
Telephone Number	:	904-466-1791
Fax Number	:	833-563-2523

Provider Business Practice Location Address
First Line	:	12058 SAN JOSE BLVD
Second Line	:	SUITE 104
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-8669
Country	:	US
Telephone Number	:	904-522-7920
Fax Number	:	833-563-2523

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. KARLY S. SHREDERS
Credential	:	MACP, LMHC
Telephone Number	:	904-466-1791

Provider Enumeration Date	:	08/21/2015
Last Update Date	:	01/12/2026

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