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

Src

Organization Community/Behavioral Health Agency · NPI 1841686433

Src is a Community/Behavioral Health Agency in Jacksonville, Florida. Registered with an NPI since 2015.

In the registry since
2015

Practice location Address checks out

580 Ellis Rd S
Jacksonville, FL 32254-3582
Phone: (678) 886-3984
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X

Record details

NPI number1841686433
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tanya Lake-Smith — Mental Health Counselor · (678) 886-3984
NPI enumeratedApril 9, 2015
Last updated in NPPESApril 9, 2015
Mailing address11993 Alexandra Dr, Jacksonville, FL 32218-8880

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