| Goolsbys Clinical Services, Llc | |
|
2720 Park St Ste 202 Jacksonville FL 32205-7645 | |
| (904) 338-2998 | |
| (844) 250-8734 |
| Full Name | Goolsbys Clinical Services, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2720 Park St Ste 202, Jacksonville, Florida |
| Authorized Official Name and Position | Kevin Goolsby (OWNER) |
| Authorized Official Contact | 9043382998 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Goolsbys Clinical Services, Llc 9233 Redtail Dr Jacksonville FL 32222-2811 Ph: (904) 338-2998 | Goolsbys Clinical Services, Llc 2720 Park St Ste 202 Jacksonville FL 32205-7645 Ph: (904) 338-2998 |
| NPI Number | 1174027130 |
|---|---|
| Provider Enumeration Date | 03/22/2018 |
| Last Update Date | 03/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174027130 | NPI | - | NPPES |
| 768184400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH12309 (Florida) | Primary |
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