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Active NPI 1326559097 Organization (Entity Type 2)

Authentically You, Llc

Community/Behavioral Health • Saint Augustine, FL

About Authentically You, Llc NPI 1326559097 Summary

Authentically You, Llc is a verified healthcare organization specializing in Community/Behavioral Health operating in Saint Augustine, FL. Located at 109 NATURE WALK PKWY UNIT 104, this facility provides patient care and medical services under National Provider Identifier (NPI) 1326559097.

Administrative operations and authorized compliance are overseen by Amanda Payne (Owner).

The facility is associated with 1 linked healthcare practitioner providing clinical services. In addition to its main center, the organization maintains 1 secondary practice location in the region.

Facility Location & Contact Primary Location

Facility Address

109 Nature Walk Pkwy Unit 104

Saint Augustine, FL 320925065

Telephone 9046291565
Fax 9045623465

Authorized Official Information

Authorized Contact Name

Amanda Payne , LMHC

Title / Role

Owner

Official Telephone

9046291565

Facility Classifications & Specialties

Community/Behavioral Health Primary Taxonomy

NUCC Taxonomy Code: 251S00000X

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

1 Linked
David Roddenberry NPI 1962217489

Counselor - Mental Health

Saint Augustine, FL

View Practitioner Profile →

Secondary Facility Locations

Verified branch offices, satellite clinics, and regional practice locations

1 Branches

701 Market St Ste 103b

Saint Augustine, FL 320958803

Phone: 9046291565

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

8 Historical Events
📍
Updated Practice Location March 12, 2019

Registered at 109 NATURE WALK PKWY UNIT 104, SAINT AUGUSTINE, FL 320925065 (Tel: 9046291565)

📍
Updated Business Mailing Address March 12, 2019

Registered at 109 NATURE WALK PKWY UNIT 104, SAINT AUGUSTINE, FL 320925065 (Tel: 9046291565)

NPI Profile Active October 20, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location October 20, 2017

Registered at 701 MARKET ST STE 103B, SAINT AUGUSTINE, FL 320958803 (Tel: 9046291565)

📍
Updated Business Mailing Address October 20, 2017

Registered at 701 MARKET STREET SUITE 111#5004, SAINT AUGUSTINE, FL 32095

🏛️
Organization / Clinic Name Updated October 20, 2017

Operating as AUTHENTICALLY YOU, LLC

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 20, 2017

Community/Behavioral Health (License #MH13243 in FL)

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Initial NPI Registration & Enumeration October 20, 2017

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

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NPI Organization Metadata

NPI Number: 1326559097
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: October 20, 2017
Last Update: March 12, 2019

Mailing Address

109 Nature Walk Pkwy Unit 104

Saint Augustine, FL 320925065

Phone: 9046291565

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.