Provider Demographics
NPI:1598137994
Name:MINDFULNESS COUNSELING CENTER OF JACKSONVILLE
Entity Type:Organization
Organization Name:MINDFULNESS COUNSELING CENTER OF JACKSONVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:INGBER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:904-686-5018
Mailing Address - Street 1:2380 3RD ST S
Mailing Address - Street 2:SUITE 2
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-4072
Mailing Address - Country:US
Mailing Address - Phone:904-599-3099
Mailing Address - Fax:904-713-2967
Practice Address - Street 1:2380 3RD ST S
Practice Address - Street 2:SUITE 2
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-4072
Practice Address - Country:US
Practice Address - Phone:904-599-3099
Practice Address - Fax:904-713-2967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-24
Last Update Date:2015-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7855MH261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health