| First Coast Family Counseling, Inc. | |
|
1718 Kingsley Ave Ste 21 Orange Park FL 32073 | |
| (904) 567-6100 | |
| (904) 602-8055 |
| Full Name | First Coast Family Counseling, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1718 Kingsley Ave Ste 21, Orange Park, Florida |
| Authorized Official Name and Position | Michael G. Mcclendon (PRESIDENT) |
| Authorized Official Contact | 9045676100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| First Coast Family Counseling, Inc. Po Box 9445 Flemming Island FL 32006 Ph: (904) 567-6100 | First Coast Family Counseling, Inc. 1718 Kingsley Ave Ste 21 Orange Park FL 32073 Ph: (904) 567-6100 |
| NPI Number | 1619032166 |
|---|---|
| Provider Enumeration Date | 12/26/2006 |
| Last Update Date | 11/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619032166 | NPI | - | NPPES |
| 767279900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 5472 (Florida) | Primary |
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