Provider Demographics
NPI:1679080824
Name:HEATHER M. FEWOX-STEEN, LMHC, LLC.
Entity type:Organization
Organization Name:HEATHER M. FEWOX-STEEN, LMHC, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:FEWOX-STEEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:904-434-2536
Mailing Address - Street 1:3955 RIVERSIDE AVE STE 2F
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-3313
Mailing Address - Country:US
Mailing Address - Phone:904-434-2536
Mailing Address - Fax:
Practice Address - Street 1:3955 RIVERSIDE AVE STE 2F
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-3313
Practice Address - Country:US
Practice Address - Phone:904-434-2536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10370261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health