Counseling Associates Clinic

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

COUNSELING ASSOCIATES CLINIC

Practice address

890 A1A Beach Blvd
Unit #5
St Augustine, FL 32080-6776

Phone

(904) 471-5623

Fax

(904) 471-7545

NPI assigned

Jan 29, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Timmothy Nelson Tillotson

Title

Owner

Phone

(904) 471-5623

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239753600000",
    "number": "1174761118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 A1A BEACH BLVD",
            "address_2": "UNIT #5",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320806776",
            "telephone_number": "904-471-5623",
            "fax_number": "904-471-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 A1A BEACH BLVD",
            "address_2": "UNIT #5",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320806776",
            "telephone_number": "904-471-5623",
            "fax_number": "904-471-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING ASSOCIATES CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-04-15",
        "status": "A",
        "authorized_official_last_name": "TILLOTSON",
        "authorized_official_first_name": "TIMMOTHY",
        "authorized_official_middle_name": "NELSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-471-5623",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hanna Cothern, MA, CCC-SLP
• Cathleen Cotton
• Leslie Danielle Couden Dileo, LMHC
• Abigail Coulson
• Kimberly Council, SLP
• Dalana Countryman-Benjamin, RBT
• County of St Johns Board of County Commissioners
• Lindsey Courson, RN
• Samantha Courson
• Laura Cowart, M.S.

• Clinical Social Worker in St Augustine, FL
• Providers in St Augustine, 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 Apr 15, 2009; 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.