# OCEANSIDE FAMILY THERAPY, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649657289
- **Authorized official:** NICOLE STORY EDS, LMFT, LMHC (PRESIDENT)
- **Authorized official phone:** (904) 234-0574

## Contact information

- **Practice address:** 328 2ND AVE N, JACKSONVILLE BEACH, FL 32250-5509
- **Practice address phone:** (904) 234-0574
- **Practice address fax:** (904) 758-5328
- **Mailing address:** 328 2ND AVE N, JACKSONVILLE BEACH, FL 32250-5509
- **Mailing address phone:** (904) 234-0574
- **Mailing address fax:** (904) 758-5328

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC1900X | Counseling Psychologist | MH7433 | FL | — |
| 106H00000X | Marriage & Family Therapist | MT2208 | FL | Yes |

## Other

- **Enumeration date:** 05/04/2015
- **Last updated:** 05/04/2015