NPIMap

Organization Active NPI

First Coast Behavior Solutions, LLC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1720326382
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH-10245 Issued in FL
Legal business name
FIRST COAST BEHAVIOR SOLUTIONS, LLC
Practice address
2317 Blanding Blvd Ste 102
Jacksonville, FL 32210
Phone
(904) 200-7979
Fax
(904) 387-5890
NPI assigned
Jan 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Authorized official

Name
Kimberly Cruise, LMHC, BCABANPI 1013245893
Title
Owner/ Clinical Director
Phone
(904) 476-8956

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MH-10245 FL Primary

Addresses

Primary practice location

2317 Blanding Blvd Ste 102
Jacksonville, FL 32210

Mailing address

2317 Blanding Blvd Ste 102
Jacksonville, FL 32210-4167
Phone (904) 200-7979

Other practice location 1

5058 Blackburn St
Jacksonville, FL 32210-4120
Phone (904) 476-8956

National Provider Directory

National Provider Directory

Locations

2317 Blanding Blvd
Ste 102
Jacksonville, FL 32210
Phone (904) 200-7979

Practitioners & affiliated clinicians

Practitioners 6

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": "1358294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1720326382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 BLANDING BLVD STE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322104167",
            "telephone_number": "904-200-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 BLANDING BLVD STE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32210",
            "telephone_number": "904-200-7979",
            "fax_number": "904-387-5890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5058 Blackburn St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322104120",
            "country_code": "US",
            "telephone_number": "904-476-8956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FIRST COAST BEHAVIOR SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-16",
        "last_updated": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "CRUISE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER/ CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "904-476-8956",
        "authorized_official_credential": "LMHC, BCABA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH-10245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.