| Hathcock Counseling, Llc | |
|
178 Worthington Pkwy St Johns FL 32259-6916 | |
| (904) 314-3380 | |
| (904) 314-3380 |
| Full Name | Hathcock Counseling, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 178 Worthington Pkwy, St Johns, Florida |
| Authorized Official Name and Position | Kared M Dixon Hathcock (OWNER) |
| Authorized Official Contact | 9043143380 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hathcock Counseling, Llc 1820 State Road North Suite 11-79 St Johns FL 32259 Ph: (904) 314-3380 | Hathcock Counseling, Llc 178 Worthington Pkwy St Johns FL 32259-6916 Ph: (904) 314-3380 |
| NPI Number | 1801625264 |
|---|---|
| Provider Enumeration Date | 08/01/2024 |
| Last Update Date | 08/01/2024 |
| Certification Date | 07/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801625264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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