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Organization
SSW COUNSELING, PLLC
Active
Organization
SSW COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTHALITTA WALLACE LMHC (OWNER)
(850) 496-0909
Entity
Organization
Contact information
Practice address
2820 GIBSON RD STE A, JACKSONVILLE, FL 32207-4804
(850) 496-0909
Mailing address
9617 WATERSHED DR E, JACKSONVILLE, FL 32220-0906
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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