Organization
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Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHIRLEY ANN RICHARDSON LMHC (OWNER)
(904) 564-0518
Entity
Organization
Contact information
Practice address
6034 CHESTER AVE STE 204, JACKSONVILLE, FL 32217-2266
(904) 564-0518
Mailing address
6034 CHESTER AVE STE 204, JACKSONVILLE, FL 32217-2266
(904) 564-0518
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH9783
FL
Other
Enumeration date
04/11/2016
Last updated
11/09/2020
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