Provider Demographics
NPI:1376043406
Name:AOL COUNSELING, COACHING AND CONSULTING SERVICES
Entity Type:Organization
Organization Name:AOL COUNSELING, COACHING AND CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, LMHC
Authorized Official - Phone:904-415-3755
Mailing Address - Street 1:44 CODO CT
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32095-7422
Mailing Address - Country:US
Mailing Address - Phone:703-870-0603
Mailing Address - Fax:
Practice Address - Street 1:157 HAMPTON POINT DR STE 1
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-3054
Practice Address - Country:US
Practice Address - Phone:904-415-3755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000OtherNONE