FAMILY THERAPY ASSOCIATES OF JACKSONVILLE LLC (NPI# 1295075190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295075190 |
| Entity Type | Organization |
| Organization Name | FAMILY THERAPY ASSOCIATES OF JACKSONVILLE LLC |
| Practice Address |
2950 Halcyon Ln Ste 605 Jacksonville FL 32223-6692 |
| Practice Telephone | 9043025340 |
| Practice Fax Number | 9048001211 |
| Mailing Telephone | 9043025340 |
| Mailing Fax Number | 9048001211 |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2016-11-08 |
| Authorized Official Name | DR. TABITHA JOHNSON (OWNER/MANAGER) |
| Authorized Official Telephone | 9043025340 |
| Authorized Official Credential | PH.D., LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | MT2673 | FL | Agencies |
| Street Address |
2950 HALCYON LN STE 605 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32223-6692 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790252 | Lauren Kay Brummitt | Counselor | 2950 Halcyon Ln Ste 605, Jacksonville, FL 32223-6692 | 2020-11-03 |
| 1639781271 | Stacy M Hernandez | Marriage & Family Therapist | 2950 Halcyon Ln Ste 605, Jacksonville, FL 32223-6692 | 2020-08-17 |
| 1407470297 | Karen B Maddox | Marriage & Family Therapist | 2950 Halcyon Ln Ste 605, Jacksonville, FL 32223-6692 | 2020-06-08 |
| 1528613338 | Elizabeth Grace Payne | Counselor | 2950 Halcyon Ln Ste 605, Jacksonville, FL 32223-6692 | 2019-08-08 |
| 1922653799 | Tyler Payne | Counselor | 2950 Halcyon Ln Ste 605, Jacksonville, FL 32223-6692 | 2019-08-07 |
| 1265099147 | Keri Ann Grant | Marriage & Family Therapist | 2950 Halcyon Ln Ste 605, Jacksonville, FL 32223-6692 | 2019-05-25 |
| 1962995696 | Frances Chomic | Marriage & Family Therapist | 2950 Halcyon Ln Ste 605, Jacksonville, FL 32223-6692 | 2018-06-07 |
| 1710478086 | April Marie Evans | Marriage & Family Therapist | 2950 Halcyon Ln Ste 605, Jacksonville, FL 32223-6692 | 2018-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679103600 | Karen Gabriela Alexander | Dietitian, Registered | Ackerman Cancer Center, 10881 San Jose Blvd, Jacksonville, FL 32223 | 2020-01-17 |
| 1891250049 | Thalia L Honea | Occupational Therapist | 12766 San Jose Blvd, Suite 716 & 717, Jacksonville, FL 32223 | 2019-02-01 |
| 1447758289 | Stephanie Ann Murphy | Marriage & Family Therapist | 11543 Halethorpe Drive, Jacksonville, FL 32223 | 2018-01-26 |
| 1861948481 | Nicole Gay | Developmental Therapist | 12276 San Jose Blvd, Ste 5, Jacksonville, FL 32223 | 2016-09-01 |
| 1740694439 | Robyn K Mizelle | Behavioral Analyst | 12276 San Jose Blvd. Great Strides Rehabilitation, Suite 507, Jacksonville, FL 32223 | 2014-06-20 |
| 1184038010 | Kelli Anne Cabrera | Occupational Therapist | 12350 San Jose Blvd, Jacksonville, FL 32223 | 2014-06-18 |
| 1891031910 | Mandarin Family Medicine, P.a. | Preferred Provider Organization | 12276-210 San Jose Blvd, Jacksonville, FL 32223 | 2012-12-18 |
| 1114201811 | Darshana Choksi | Pharmacist | 3663 Marbon Rd, Jacksonville, FL 32223 | 2011-09-30 |
| 1346539988 | Harris Wilcox and Donovan Pa | Optometrist | 11790 San Jose Bl, Jacksonville, FL 32223 | 2011-04-05 |
| 1740517796 | Beth A. Kelley | Occupational Therapist | 2640 Scott Mill Dr, Jacksonville, FL 32223 | 2009-11-12 |
| Find all providers in zip 32223 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, 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. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427632 | Sunzup Counseling and Wellness | Community/Behavioral Health | 3355 Claire Ln Apt 1116, Jacksonville, FL 32223-6662 | 2020-11-02 |
| 1063043420 | Elephant Clinic Ltd. | Community/Behavioral Health | 8 Unf Dr # 221, Jacksonville, FL 32224-7699 | 2020-02-03 |
| 1679056857 | Inspire To Rise Inc. | Community/Behavioral Health | 4603 Silverthorn Dr, Jacksonville, FL 32258-2010 | 2018-09-13 |
| 1558863787 | Positive Development, LLC | Community/Behavioral Health | 3840 Belfort Rd Ste 302, Jacksonville, FL 32216-8210 | 2018-03-04 |
| 1073012555 | Pivotal Step Services, Pllc | Community/Behavioral Health | 1106b Gum Branch Rd, Jacksonville, NC 28540-5743 | 2018-02-09 |
| 1518473594 | Werp LLC | Community/Behavioral Health | 5291 Collins Rd Lot 293, Jacksonville, FL 32244-5389 | 2017-12-28 |
| 1871007062 | National Youth Advocate Program, Inc | Community/Behavioral Health | 2200 Rosselle St, Jacksonville, FL 32204-3126 | 2017-11-27 |
| 1962913327 | Port Health Services | Community/Behavioral Health | 224 Memorial Dr Ste B, Jacksonville, NC 28546-6332 | 2017-10-12 |
| 1598282667 | B.e.h. Elderly Care LLC | Community/Behavioral Health | 5145 Timuquana Rd Apt 6, Jacksonville, FL 32210-8923 | 2017-08-29 |
| 1427598689 | Family Farms of Northeast Florida | Community/Behavioral Health | 16844 Ethel Rd, Jacksonville, FL 32218-1108 | 2017-03-06 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32223 |
Please comment or provide details below to improve the information on FAMILY THERAPY ASSOCIATES OF JACKSONVILLE LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.