Christian Counseling Associates of Jacksonville

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

License

LCMFT 0413020312 Issued in FL

Legal business name

CHRISTIAN COUNSELING ASSOCIATES OF JACKSONVILLE

Practice address

822 A1A N Ste 310
Ponte Vedra Beach, FL 32082-8209

Phone

(904) 758-4399

NPI assigned

Jul 3, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Andrew T Jacobs, MA

Title

President

Phone

(904) 509-4253

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467504000000",
    "number": "1134571078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 BARBERRY LN",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823000",
            "telephone_number": "904-509-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 A1A N STE 310",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320828209",
            "telephone_number": "904-758-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN COUNSELING ASSOCIATES OF JACKSONVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-03",
        "last_updated": "2016-07-03",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-509-4253",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "FL",
            "license": "LCMFT 0413020312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clayton Christopher Celander, DMD
• Stephanie Michelle Ceparano
• Adam I. Chaifetz, D.C.
• Charles Perniciaro MD PA (Neptune Beach Dermatology)
• Charles V Perniciaro, M.D., P.C., D/B/a Brunswick Dermatology Clinic (Brunswick Dermatology Clinic)
• Chae Hyung Chung
• Lauren Church
• Jessica Marie Clark, APRN
• Mary Kenley Clark, LICSW
• Claudia Rojas-Baisden

• Voluntary or Charitable Agency in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Voluntary or Charitable Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.