Provider Demographics
NPI:1366692493
Name:FIRST COAST CENTER FOR COUNSELING INC
Entity Type:Organization
Organization Name:FIRST COAST CENTER FOR COUNSELING INC
Other - Org Name:ELIZABETH D. PASCOE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:DOWELL
Authorized Official - Last Name:PASCOE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:904-269-7200
Mailing Address - Street 1:165 WELLS ROAD SUI
Mailing Address - Street 2:SUITE 408
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-3035
Mailing Address - Country:US
Mailing Address - Phone:904-269-7200
Mailing Address - Fax:904-269-0070
Practice Address - Street 1:165 WELLS ROAD
Practice Address - Street 2:SUITE 408
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-3035
Practice Address - Country:US
Practice Address - Phone:904-269-7200
Practice Address - Fax:904-269-0070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW81041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty