Provider Demographics
NPI:1750863130
Name:COMPREHENSIVE COUNSELING AND FAMILY SERVICES, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE COUNSELING AND FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:DENITA
Authorized Official - Last Name:SHEALEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:904-404-8113
Mailing Address - Street 1:3115 SPRING GLEN RD STE 504
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-5907
Mailing Address - Country:US
Mailing Address - Phone:904-404-8113
Mailing Address - Fax:904-453-8668
Practice Address - Street 1:3115 SPRING GLEN RD STE 504
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-5907
Practice Address - Country:US
Practice Address - Phone:904-404-8113
Practice Address - Fax:904-453-8668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-03
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty