Organization
BEACHES BEHAVIORAL HEALTH LLC
Active
Other names
PsychLife
Organization subpart
No
Provider details
NPI number
Authorized official
LISA J ROTELLA LCSW (OWNER)
(610) 331-2645
Entity
Organization
Contact information
Practice address
3733 UNIVERSITY BLVD W STE 209, JACKSONVILLE, FL 32217-2103
(904) 543-6055
(904) 395-9181
Mailing address
6652 EPPING FOREST WAY N, JACKSONVILLE, FL 32217-2648
(904) 280-0790
(904) 395-9181
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW13084
FL
Other
Enumeration date
10/23/2015
Last updated
09/17/2021
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