Provider Demographics
NPI:1346996477
Name:AMD COUNSELING & CONSULTING, LLC
Entity Type:Organization
Organization Name:AMD COUNSELING & CONSULTING, LLC
Other - Org Name:TAPESTRY BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMPSEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, BCBA
Authorized Official - Phone:904-419-9864
Mailing Address - Street 1:4530 SAINT JOHNS AVE STE 15-214
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-1852
Mailing Address - Country:US
Mailing Address - Phone:904-419-9864
Mailing Address - Fax:904-212-0929
Practice Address - Street 1:1912 HAMILTON ST STE 108
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-2077
Practice Address - Country:US
Practice Address - Phone:904-419-9864
Practice Address - Fax:904-212-0929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-28
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018152000Medicaid