Organization
EBTIDE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY DAVIS LCSW (OWNER)
(904) 338-1259
Entity
Organization
Contact information
Practice address
3100 UNIVERSITY BLVD S STE 218, JACKSONVILLE, FL 32216-2727
(904) 338-1259
(904) 212-2509
Mailing address
PO BOX 2384, JACKSONVILLE, FL 32203-2384
(904) 338-1259
(904) 212-2509
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/08/2018
Last updated
10/08/2018
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