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Organization

OCEANSIDE FAMILY THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE STORY EDS, LMFT, LMHC (PRESIDENT)
(904) 234-0574
Entity
Organization

Contact information

Practice address
328 2ND AVE N, JACKSONVILLE BEACH, FL 32250-5509
(904) 234-0574
(904) 758-5328
Mailing address
328 2ND AVE N, JACKSONVILLE BEACH, FL 32250-5509
(904) 234-0574
(904) 758-5328

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
MH7433
FL
106H00000X
Marriage & Family Therapist
Primary
MT2208
FL

Other

Enumeration date
05/04/2015
Last updated
05/04/2015
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