Manther's Place Counseling LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH11902 Issued in FL

Legal business name

MANTHER'S PLACE COUNSELING LLC

Practice address

6108 Arlington Rd
Jacksonville, FL 32211-5420

Phone

(904) 743-2327

Fax

(904) 743-2353

NPI assigned

Dec 7, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Connie E Clark, MA, CCTP,CST

Title

Ceo, Psychotherapist

Phone

(904) 743-2327

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449446400000",
    "number": "1235504978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6108 ARLINGTON RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322115420",
            "telephone_number": "904-743-2327",
            "fax_number": "904-743-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6108 ARLINGTON RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322115420",
            "telephone_number": "904-743-2327",
            "fax_number": "904-743-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANTHER'S PLACE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-07",
        "last_updated": "2015-12-07",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO, PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "904-743-2327",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, CCTP,CST"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "ADC-010509-2015",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH11902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Marie Mansour, MD
• Kathryn Mary Mansueti
• Kadir Mansur, MD
• Steven A Mantegari, DDS, MD
• Kalyan Mantha, MD
• Manthers Place Counseling
• Sarah Mantia, MMSC
• Jose Oscar Mantilla-Rivas
• Amelia Elizabeth Wharen Mantione, M.S.N., APRN, AGACNP
• Manuel Y Paulino

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; 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.