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
7235 BENTLEY RD STE 308, JACKSONVILLE, FL 32256-7506
(904) 990-7117
Mailing address
3733 UNIVERSITY BLVD W STE 203, JACKSONVILLE, FL 32217-2152
(904) 990-7117
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1117302000
—
FL
Enumeration date
07/28/2019
Last updated
08/08/2025
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