Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Prodigal S D Corporation

Organization Addiction (Substance Use Disorder) Counselor · NPI 1184153934

Prodigal S D Corporation is an Addiction (Substance Use Disorder) Counselor in Jacksonville, Florida. Registered with an NPI since 2017.

In the registry since
2017
Specialties on file
5
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Practice location Address checks out

9521 Shellie Rd Ste 13
Jacksonville, FL 32257-6174
Phone: (904) 930-4244
Fax: (954) 256-8140
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X
Mental Health Counselor Taxonomy 101YM0800X
Pastoral Counselor Taxonomy 101YP1600X
Professional Counselor Taxonomy 101YP2500X
Group Psychotherapy Psychologist Taxonomy 103TP2701X

Record details

NPI number1184153934
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProdigal S D Corporation
Authorized official Freda Stevens — Executive Director · (904) 930-4244
Other names Prodigal Kids
NPI enumeratedJune 6, 2017
Last updated in NPPESJune 6, 2017
Mailing address9838 Old Baymeadows Rd # 267, Jacksonville, FL 32256-8101

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