Provider Demographics
NPI:1699908186
Name:DROZD, ALLEN (LMHC, NCC)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:DROZD
Suffix:
Gender:M
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303B ANASTASIA BLVD
Mailing Address - Street 2:#159
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-4506
Mailing Address - Country:US
Mailing Address - Phone:904-687-1592
Mailing Address - Fax:866-902-0819
Practice Address - Street 1:24 CATHEDRAL PL
Practice Address - Street 2:SUITE 400
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-4473
Practice Address - Country:US
Practice Address - Phone:904-687-1592
Practice Address - Fax:866-902-0819
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0003697101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ7082OtherBCBS