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Organization
AUTHENTIC SELF COUNSELING OF JACKSONVILLE, LLC
Active
Organization
AUTHENTIC SELF COUNSELING OF JACKSONVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE ANDERSON (OWNER)
(904) 990-7117
Entity
Organization
Contact information
Practice address
910 S 8TH ST STE 100, FERNANDINA BEACH, FL 32034-3745
(904) 894-3867
Mailing address
910 S 8TH ST STE 100, FERNANDINA BEACH, FL 32034-3745
(904) 894-3867
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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