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Organization
PHAITH COACHING & COUNSELING, LLC
Active
Organization
PHAITH COACHING & COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PHYLICIA MASSEY LCSW (LICENSED CLINICAL SOCIAL WORKER)
(904) 323-6801
Entity
Organization
Contact information
Practice address
4940 EMERSON ST, JACKSONVILLE, FL 32207-4963
(904) 323-6801
(904) 328-1626
Mailing address
8106 SIERRA OAKS BLVD, JACKSONVILLE, FL 32219-3902
(904) 323-6801
(904) 328-1626
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376817551
PERSONAL NPI
FL
Enumeration date
05/21/2020
Last updated
05/21/2020
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