Black Canary Therapy LLC
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · St Johns, FL
NPI 1083597918 · NPPES record last updated Jul 29, 2025
Key facts
- NPI
- 1083597918
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- BLACK CANARY THERAPY LLC
- Practice address
- 621 Melrose Abbey LN
St Johns, FL 32259-5906 - Phone
- (850) 524-1616
- NPI assigned
- Jul 29, 2025
- Organization subpart
- No
Authorized official
- Name
- Megan London
- Title
- Owner
- Phone
- (850) 524-1616
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
621 Melrose Abbey LN
St Johns, FL 32259-5906
Mailing address
621 Melrose Abbey LN
St Johns, FL 32259-5906
Other names
- Lifeologie Counseling St Johns
Other providers in St Johns, FL
- Michelle Bennett
- Henry Donald Benson Jr.
- Vanessa M. Berrios
- Better Families Counseling, PLLC
- BJ'S Wholesale Club Inc.
- Black Sheep Counseling LLC
- Kelsey L. Bloom
- Peyton Lightning Bolt
- Joseph William Bonura
- Margaret Suzanne Booher
All providers in St Johns, FL · Mental Health Clinic/Center (Including Community Mental Health Center) in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.