Organization
BEYOND THE COUCH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIE DIANE EBERWEIN PHD., LMHC, CAP (CO-FOUNDER)
(904) 863-6746
Entity
Organization
Contact information
Practice address
516 S 10TH ST STE 119, FERNANDINA BEACH, FL 32034-3511
(904) 863-6746
(347) 412-5958
Mailing address
PO BOX 15905, FERNANDINA BEACH, FL 32035-3116
(904) 863-6746
(347) 412-5958
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH9903
FL
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001116400
—
FL
Enumeration date
07/05/2018
Last updated
07/05/2018
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