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SOUTHSIDE COUNSELING BIOFEEDBACK AND STRESS MANAGEMENT CENTER NPI 1679637961


NPI Information

NPI: 1679637961
Provider Name: SOUTHSIDE COUNSELING BIOFEEDBACK AND STRESS MANAGEMENT CENTER
Classification: Counselor - 101Y00000X
Entity Type: Organization

CLIA Number: 10D1031688

Address:
5730 BOWDEN RD
105
JACKSONVILLE, FL
ZIP 32216
Phone: (904) 737-6700
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SOUTHSIDE COUNSELING BIOFEEDBACK AND STRESS MANAGEMENT CENTER is a counselor in Jacksonville, FL. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. SOUTHSIDE COUNSELING BIOFEEDBACK AND STRESS MANAGEMENT CENTER NPI is 1679637961. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5730 BOWDEN RD
105
JACKSONVILLE, FL
ZIP 32216-104
Phone: (904) 737-6700
Fax: (904) 737-6774

The provider's authorized official is Solomon Stanford .
The authorized official title is Office Manager and has the following contact phone number (904) 737-6700.

The CLIA number assigned to this NPI record is 10D1031688 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/20/2006 and was last updated on 4/16/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorMH0003114FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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