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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