MS. MARY ANN SUMMERLIN (NPI# 1487062824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487062824 |
| Entity Type | Individual |
| Full Name | MS. MARY ANN SUMMERLIN |
| Credential | LPCA |
| Practice Address |
201 New Bridge St Suite 105 Jacksonville NC 28540-4736 |
| Practice Telephone | 9103364958 |
| Practice Fax Number | 9103339742 |
| Mailing Telephone | 9103364958 |
| Mailing Fax Number | 9103339742 |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2017-02-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LCAS - 21026 | NC | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
11015 | NC | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609925924 | Mary Lue Summerlin | Psychologist | 1525 Lakeville Dr, Kingwood, TX 77339-2067 | 2007-01-09 |
| Street Address |
201 NEW BRIDGE ST SUITE 105 |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28540-4736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740381102 | Nora Rebecca Lewis | Social Worker | 201 New Bridge St, Suite 208, Jacksonville, NC 28540-4736 | 2006-09-26 |
| 1841838851 | Belinda Prescott | Counselor | 201 New Bridge St, Jacksonville, NC 28540-4736 | 2019-12-20 |
| 1790322535 | Ashley Jerread | Social Worker | 201 New Bridge St, Jacksonville, NC 28540-4736 | 2019-11-27 |
| 1164969036 | Brighter Life Counseling Pllc | Community/Behavioral Health | 201 New Bridge St, Jacksonville, NC 28540-4736 | 2017-01-30 |
| 1346585817 | Dawn Y Wright | Counselor | 201 New Bridge St, Suite 208, Jacksonville, NC 28540-4736 | 2012-12-10 |
| 1427290105 | Dejuan Joyce Lundy | Counselor | 201 New Bridge St, Suite 203, Jacksonville, NC 28540-4736 | 2009-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467067785 | Knox Counseling and Consulting, PC | Case Management | 513 New Bridge St-suite 500, Jacksonville, NC 28540 | 2020-09-14 |
| 1629696646 | Mary Ann Caldwell | Counselor | 2496 Northwoods Dr., Jacksonville, NC 28540 | 2020-07-07 |
| 1639793748 | Johnathon T Brewer | Military Health Care Provider | 100 White St, Jacksonville, NC 28540 | 2020-06-04 |
| 1043782899 | Brice Rivra | Military Health Care Provider | Rr 612 Loop Road, Jacsksonvile, NC 28540 | 2018-12-18 |
| 1649768599 | Alexander John Pybus | Student in an Organized Health Care Education/Training Program | White St Bldg As-100, Jacksonville, NC 28540 | 2018-04-26 |
| 1881198182 | Orleiquis Guerra | Military Health Care Provider | Marine Corps Air Station New River Bldg As-100, Jacksonville, NC 28540 | 2018-03-21 |
| 1558864736 | Andrew Louis Monroe | General Practice | As-100 White Street, Jacksonville, NC 28540 | 2018-03-14 |
| 1588183198 | Citizen Community Transport, LLC | Private Vehicle | 220 Foxwood Ct., Jacksonville, NC 28540 | 2017-09-14 |
| 1558886242 | Brandon Jay Smith | Military Health Care Provider | E Street Bldg G770, Camp Lejeune, NC 28540 | 2017-08-03 |
| 1174043244 | Jason Waters | Military Health Care Provider | White St, Bldg As-100, Jacksonville, NC 28540 | 2017-06-21 |
| Find all providers in zip 28540 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720519 | Ashley Harms | Counselor | 4070 Herschel St Ste 1, Jacksonville, FL 32210-2239 | 2020-11-03 |
| 1902418684 | Molly Ann Burkhardt | Counselor | 5776 Saint Augustine Rd # 8030, Jacksonville, FL 32207-8046 | 2020-08-23 |
| 1194335638 | Aiteria Green | Counselor | 9713 Bridgeway Ave, Jacksonville, FL 32222-2913 | 2020-08-07 |
| 1053920116 | Barbara Burden | Counselor | 209 N Carole Dr, Jacksonville, NC 28546-4845 | 2020-07-24 |
| 1790393973 | Kelley Holladay | Counselor | 1782 Plantation Oaks Dr, Jacksonville, FL 32223-5010 | 2020-07-14 |
| 1629696646 | Mary Ann Caldwell | Counselor | 2496 Northwoods Dr., Jacksonville, NC 28540 | 2020-07-07 |
| 1447877709 | Quendria Johnson-kerns | Counselor | 200 Zonnie Ln, Jacksonville, NC 28540-9729 | 2020-07-02 |
| 1467077164 | Shanna Horan | Counselor | 13500 Sutton Park Dr S Ste 702, Jacksonville, FL 32224-5290 | 2020-06-09 |
| 1720602527 | Shannon E Raikes | Counselor | 13990 Bartram Park Blvd Unit 209, Jacksonville, FL 32258-5543 | 2020-06-08 |
| 1750905253 | Kathlena N Reed | Counselor | 4131 University Blvd S Fl 32216, Jacksonville, FL 32216-4326 | 2020-06-01 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28540 |
Please comment or provide details below to improve the information on MS. MARY ANN SUMMERLIN.
| 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.