Provider Demographics
NPI:1588073910
Name:CIPRIANO&JOHNSON COUNSELING LLC
Entity type:Organization
Organization Name:CIPRIANO&JOHNSON COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, CAP
Authorized Official - Phone:904-503-2634
Mailing Address - Street 1:2602 ISABELLA BLVD
Mailing Address - Street 2:SUITE 30
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-4099
Mailing Address - Country:US
Mailing Address - Phone:904-372-4349
Mailing Address - Fax:904-595-5628
Practice Address - Street 1:2602 ISABELLA BLVD
Practice Address - Street 2:SUITE 30
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-4099
Practice Address - Country:US
Practice Address - Phone:904-372-4349
Practice Address - Fax:904-595-5628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0416AD889502251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health