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Prodigal S D Corporation
Group Psychotherapy Psychologist in Jacksonville, Florida
NPI 1184153934

Prodigal S D Corporation is a Group Psychotherapy Psychologist based in Jacksonville, FL and is specialized in Group Psychotherapy. Prodigal S D Corporation practices in Jacksonville, FL. The NPI Number for Prodigal S D Corporation is 1184153934 and holds a License No. (Florida).

The current practice location address for Prodigal S D Corporation is 9521 Shellie Rd Ste 13, Jacksonville, FL and can be reached out via phone at 904-930-4244 and via fax at 954-256-8140.

Location: 9521 Shellie Rd Ste 13, Jacksonville, FL, 32256-8101
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1184153934
Provider Name
Prodigal S D Corporation
Credential
Provider Entity Type
Organization
Address
9521 Shellie Rd Ste 13, Jacksonville, FL, 32256-8101
Phone Number
904-930-4244
Fax Number
954-256-8140
Provider Enumeration Date
06/06/2017
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
9521 Shellie Rd Ste 13
City
Jacksonville
State
Florida
Zip
32257-6174
Phone Number
904-930-4244
Fax Number
954-256-8140
person
Provider Business Mailing Address Details
Address
9521 Shellie Rd Ste 13
City
Jacksonville
State
Florida
Zip
32257-6174
Phone Number
904-930-4244
Fax Number
954-256-8140
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Pastoral
Taxonomy
101YP1600X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 5
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Group Psychotherapy
Taxonomy
103TP2701X
License No.
()
Definition
A psychologist who specializes in group psychology and group psychotherapy that is an evidenced-based specialty that prepares group leaders to identify and capitalize on developmental and healing possibilities embedded in the interpersonal/intrapersonal functioning of individual group members as well as collectively for the group. Emphasis is placed on the use of group dynamics to assist and treat individual group members. The specialty is applicable to all age groups, children, adolescents, adults and older adults, for a wide variety of conditions and concerns, and in numerous and diverse settings.
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