EDISA SHIRLEY PHD, LMHC
NPI 1700609344
Counselor - Mental Health in Jacksonville, FL
Active since November 04, 2024
About Edisa Shirley Phd, Lmhc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EDISA SHIRLEY PHD, LMHC (NPI 1700609344) is an individual mental health provider in Jacksonville, Florida, licensed in Florida (MH17531) and active in the NPI registry since November 2024.
NPPES Registry Identity
NPI1700609344
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameEDISA SHIRLEYCredential: PHD, LMHC
Location Address538 CANDLEBARK DRJacksonville, FL 32225-5358
Mailing Address538 Candlebark DrJacksonville, FL 32225-5358 · (904) 294-7041
Phone(904) 294-7041
Sole ProprietorNo
Enumeration DateNovember 4, 2024
NPPES CertifiedNovember 3, 2024
✔ NPI 1700609344 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in FL · MH17531
538 CANDLEBARK DR, Jacksonville, FL 32225
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1700609344, enumerated as an "individual" on November 04, 2024.
The provider is located at 538 CANDLEBARK DR JACKSONVILLE, FL 32225 and the phone number is (904) 294-7041.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
