Provider Demographics
NPI:1679965230
Name:BEACHES COUNSELING & THERAPY
Entity Type:Organization
Organization Name:BEACHES COUNSELING & THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE& FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTNER MCDOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:904-853-3300
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:904-853-3300
Mailing Address - Fax:
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:904-853-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-19
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2927106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty