Organization
BEACH STREET COUNSELING, LLC
Active
Organization
BEACH STREET COUNSELING, LLC
Active
Other names
Beach Street Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNIE JENUWINE LCSW, LMSW, CAADC (OWNER)
(386) 299-0026
Entity
Organization
Contact information
Practice address
140 S BEACH ST STE 414, DAYTONA BEACH, FL 32114-4472
(386) 299-0026
Mailing address
140 S BEACH ST STE 414, DAYTONA BEACH, FL 32114-4472
(386) 299-0026
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851672646
NPI
MI
Enumeration date
10/17/2023
Last updated
10/17/2023
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