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Organization
INNOVATION COUNSELING CENTER
Active
Organization
INNOVATION COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA MALONE LMHC (CEO)
(904) 719-1043
Entity
Organization
Contact information
Practice address
9951 ATLANTIC BLVD, 442, JACKSONVILLE, FL 32225-6584
(904) 274-6255
Mailing address
9951 ATLANTIC BLVD, 442, JACKSONVILLE, FL 32225-6584
(904) 327-4261
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH13087
FL
Other
Enumeration date
04/15/2015
Last updated
11/29/2016
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