Organization
NIGHTINGALE BEHAVIORAL AND COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA LARA LMHC, BCBA (OWNER, LMHC, BCBA)
(904) 596-9986
Entity
Organization
Contact information
Practice address
406 MCINTOSH AVE, ORANGE PARK, FL 32073-4834
(904) 596-9986
(904) 596-9988
Mailing address
1142 GARRISON DR, ST AUGUSTINE, FL 32092-1019
(904) 596-9986
(904) 596-9988
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
MH12293
FL
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
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