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PRODIGAL KIDS
NPI 1184153934
Counselor - Addiction (Substance Use Disorder) in Jacksonville, FL

Active since June 06, 2017
9521 SHELLIE RD STE 13, JACKSONVILLE, FL 32257(904) 930-4244(954) 256-8140 Get Directions Write a Review

NPPES record last updated: June 6, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Prodigal Kids NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRODIGAL KIDS (NPI 1184153934) is a healthcare organization registered as an addiction (substance use disorder) in Jacksonville, Florida and active in the NPI registry since June 2017. The organization lists Freda Stevens, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1184153934
Entity TypeOrganization
Primary Taxonomy101YA0400X
Legal Business NamePRODIGAL S D CORPORATION
Location Address9521 SHELLIE RD STE 13Jacksonville, FL 32257-6174
Mailing Address9838 Old Baymeadows Rd # 267Jacksonville, FL 32256-8101 · (904) 930-4244 · Fax (954) 256-8140
Phone(904) 930-4244
Fax(954) 256-8140
Organization SubpartYes
Authorized OfficialFreda StevensExecutive Director · (904) 930-4244
Enumeration DateJune 6, 2017
✔ NPI 1184153934 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedCounselor · PastoralTaxonomy 101YP1600X
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X
Also ListedPsychologist · Group PsychotherapyTaxonomy 103TP2701X
9521 SHELLIE RD STE 13, Jacksonville, FL 32257
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Other Names 1

Doing Business AsProdigal Kids

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRITTANY BEATTIE LMHC
Counselor (Mental Health)
9521 SHELLIE RD STE 13
JACKSONVILLE, FL 32257
Duval County (904) 257-6835
BLOSSOM FORWARD LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
9521 SHELLIE RD STE 13
JACKSONVILLE, FL 32257
Duval County (904) 257-6835
DARIC STEVENS
Counselor (Addiction (Substance Use Disorder))
9521 SHELLIE RD STE 13
JACKSONVILLE, FL 32257
Duval County (904) 930-4244

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prodigal S D Corporation's NPI number?

The NPI number for Prodigal S D Corporation is 1184153934. It was assigned to this organization in the NPPES registry on June 6, 2017. The provider is doing business as Prodigal Kids.

Where is Prodigal S D Corporation located?

Prodigal S D Corporation is located at 9521 Shellie Rd Ste 13, Jacksonville, FL 32257. The listed phone number is (904) 930-4244.

What is Prodigal S D Corporation's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Prodigal S D Corporation was last updated on June 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.