Provider Demographics
NPI:1639297179
Name:BEHRENS, ALISON LEE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:LEE
Last Name:BEHRENS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 VISTA GRANDE DR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-1763
Mailing Address - Country:US
Mailing Address - Phone:904-280-9380
Mailing Address - Fax:
Practice Address - Street 1:2320 3RD ST S
Practice Address - Street 2:SUITE 12
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-4058
Practice Address - Country:US
Practice Address - Phone:904-247-1117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4713101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health