Provider Demographics
NPI:1689710303
Name:BARUFALDI, ANNE LAURA (LMHC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:LAURA
Last Name:BARUFALDI
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:PO BOX 17812
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32245-7812
Mailing Address - Country:US
Mailing Address - Phone:904-996-7447
Mailing Address - Fax:904-996-7447
Practice Address - Street 1:2370 3RD ST S STE 1
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-4023
Practice Address - Country:US
Practice Address - Phone:904-996-7447
Practice Address - Fax:904-996-7447
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4805101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health