Dakota Ray Czerniak, MS

Individual provider Active NPI Mental Health Counselor · Neptune Beach, FL

NPI 1407513245 · NPPES record last updated Nov 29, 2021

Key facts

NPI
1407513245
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
IMH18056 (FL)
Practice address
804 3Rd St
Neptune Beach, FL 32266-5040
Phone
(904) 801-9563
NPI assigned
Nov 29, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
IMH18056FLMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YM0800X IMH18056 FL Yes

Addresses

Primary practice location

804 3Rd St
Neptune Beach, FL 32266-5040

Mailing address

12603 Ashmore Green Dr N
Jacksonville, FL 32246-7239
Phone (407) 467-0833

Other providers in Neptune Beach, FL

All providers in Neptune Beach, FL · Mental Health Counselor in Florida

Sources for this page

Verify at the official NPI Registry.