Provider Demographics
NPI:1982266490
Name:HOAG, FERNETTE R (LMHC, CAP)
Entity Type:Individual
Prefix:
First Name:FERNETTE
Middle Name:R
Last Name:HOAG
Suffix:
Gender:F
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7724 MEADOW WALK LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-8070
Mailing Address - Country:US
Mailing Address - Phone:904-553-7362
Mailing Address - Fax:
Practice Address - Street 1:1225 W BEAVER ST STE 120
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-1415
Practice Address - Country:US
Practice Address - Phone:904-553-7362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLADC-005023-2014101YA0400X
FLMH14427101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)