Organization
FAMILY COUNSELING & PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH F. JOHNSON DR. (ADMINISTRATOR OF BUSINESS)
(386) 235-3831
Entity
Organization
Contact information
Practice address
5422 FIRST COAST HWY, STE 119, AMELIA ISLAND, FL 32034-5423
(904) 432-7617
(904) 432-7088
Mailing address
5422 FIRST COAST HWY, STE 119, AMELIA ISLAND, FL 32034-5423
(904) 432-7617
(904) 432-7088
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
5460
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
5460
FL
101YM0800X
Mental Health Counselor
5548
FL
101YP1600X
Pastoral Counselor
5460
FL
103T00000X
Psychologist
5548
FL
103TE1100X
Exercise & Sports Psychologist
5548
FL
251S00000X
Community/Behavioral Health Agency
MH5548
FL
Other
Enumeration date
07/25/2012
Last updated
01/21/2015
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