Lifestyle Management Counseling Center, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW004714 Issued in GA

Legal business name

LIFESTYLE MANAGEMENT COUNSELING CENTER, LLC

Practice address

2404 Hubbard St
Jacksonville, FL 32206-2911

Phone

(904) 902-2454

Fax

(888) 474-2998

NPI assigned

Sep 24, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Stephanie McElveen, LCSWNPI 1548306475

Title

Owner

Phone

(904) 902-2454

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Stephanie McElveen, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1548306475
  NPD Authorized official

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1376894816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 HUBBARD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322062911",
            "telephone_number": "904-902-2454",
            "fax_number": "888-474-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 HUBBARD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322062911",
            "telephone_number": "904-902-2454",
            "fax_number": "888-474-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE MANAGEMENT COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-24",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "MCELVEEN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-902-2454",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Oct 22, 2024; 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.