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Organization

FIRST COAST FAMILY COUNSELING, INC.

Active
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Organization

FIRST COAST FAMILY COUNSELING, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL G. MCCLENDON LMHC-MA (PRESIDENT)
(904) 567-6100
Entity
Organization

Contact information

Practice address
1718 KINGSLEY AVE STE 21, ORANGE PARK, FL 32073
(904) 567-6100
(904) 602-8055
Mailing address
PO BOX 9445, FLEMMING ISLAND, FL 32006
(904) 567-6100
(904) 602-8055

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5472
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
767279900
—
FL
Enumeration date
12/26/2006
Last updated
11/09/2018
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