Elizabeth Southard, Lmhc, Llc | |
690a W Macclenny Ave Macclenny FL 32063-2080 | |
(904) 400-0517 | |
Not Available |
Full Name | Elizabeth Southard, Lmhc, Llc |
---|---|
Speciality | Counselor - Mental Health |
Location | 690a W Macclenny Ave, Macclenny, Florida |
Authorized Official Name and Position | Mary Elizabeth Southard (OWNER) |
Authorized Official Contact | 9044000517 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Elizabeth Southard, Lmhc, Llc 5570 Huckleberry Trl N Macclenny FL 32063-1803 Ph: (904) 885-9948 | Elizabeth Southard, Lmhc, Llc 690a W Macclenny Ave Macclenny FL 32063-2080 Ph: (904) 400-0517 |
NPI Number | 1841802683 |
---|---|
Provider Enumeration Date | 08/22/2020 |
Last Update Date | 04/17/2021 |
Certification Date | 04/17/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841802683 | NPI | - | NPPES |
021509900 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
News Archive
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