Fresh Start Counseling, PA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

FRESH START COUNSELING, PA

Practice address

12443 San Jose Blvd Ste 202
Jacksonville, FL 32223-8648

Phone

(904) 428-8331

Fax

(904) 320-0754

NPI assigned

Jan 16, 2022

Organization subpart

No

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

Authorized official

Name

Christie Matlosz, LCSWNPI 1730781634

Title

Owner

Phone

(904) 428-8331

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christie Matlosz, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1730781634
  NPD Authorized official

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

{
    "created_epoch": "1642291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642291200000",
    "number": "1174274658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12443 SAN JOSE BLVD STE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238648",
            "telephone_number": "904-428-8331",
            "fax_number": "904-320-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12443 SAN JOSE BLVD STE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238648",
            "telephone_number": "904-428-8331",
            "fax_number": "904-320-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH START COUNSELING, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-16",
        "last_updated": "2022-01-16",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "MATLOSZ",
        "authorized_official_first_name": "CHRISTIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-428-8331",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frejen Corporation
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• Sarah French, SLP
• Kaitlyn Frening
• Fresh Heads Lice Removal
• Fresh Start Speech Therapy Services LLC.
• Kaleigh Freshcorn, PA-C
• Ainsley Busha Freshour, M.D.
• Charmesia E Freshwater
• Heidi L Fretheim

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2022; 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.