NPIMap

Organization Active NPI

Oceanside Family Therapy, LLC

  • Marriage & Family Therapist
  • Jacksonville Beach, FL
National Provider Identifier
1649657289
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT2208 Issued in FL
Legal business name
OCEANSIDE FAMILY THERAPY, LLC
Practice address
328 2ND Ave N
Jacksonville Beach, FL 32250-5509
Phone
(904) 234-0574
Fax
(904) 758-5328
NPI assigned
May 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Authorized official

Name
Nicole Story, EDS, LMFT, LMHCNPI 1811225485
Title
President
Phone
(904) 234-0574

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X MH7433 FL
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X MT2208 FL Primary

Addresses

Primary practice location

328 2ND Ave N
Jacksonville Beach, FL 32250-5509

Mailing address

328 2ND Ave N
Jacksonville Beach, FL 32250-5509
Phone (904) 234-0574

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1649657289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 2ND AVE N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505509",
            "telephone_number": "904-234-0574",
            "fax_number": "904-758-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 2ND AVE N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505509",
            "telephone_number": "904-234-0574",
            "fax_number": "904-758-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEANSIDE FAMILY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "STORY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-234-0574",
        "authorized_official_credential": "EDS, LMFT, LMHC"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "MH7433",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT2208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.