TRACY RILEY COUNSELING LLC (NPI# 1902239270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902239270 |
| Entity Type | Organization |
| Organization Name | TRACY RILEY COUNSELING LLC |
| Practice Address |
10151 Deerwood Park Blvd Ste 200-250 Jacksonville FL 32256 |
| Mailing Address |
10151 Deerwood Park Blvd Ste 200-250 Jacksonville FL 32256-0589 |
| Practice Telephone | 9047042527 |
| Mailing Telephone | 9047042527 |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2018-08-10 |
| Authorized Official Name | TRACY M RILEY (OWNER) |
| Authorized Official Telephone | 9047042527 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
MH 5716 | FL | Behavioral Health & Social Service Providers |
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
ME0045122 | FL | Allopathic & Osteopathic Physicians |
| N | 251S00000X | Community/Behavioral Health | FL | Agencies | |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
SW9355 | FL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 008697300 | 05 |
| Street Address |
10151 DEERWOOD PARK BLVD STE 200-250 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679762553 | Tracy M Riley | Social Worker | 10151 Deerwood Park Blvd Ste 200-250, Jacksonville, FL 32256 | 2007-10-17 |
| 1265891816 | Diane Gellermann | Nurse Practitioner | 10151 Deerwood Park Blvd Ste 200-250, Jacksonville, FL 32256-0589 | 2016-02-10 |
| 1003256215 | Icats Lakeland LLC | Nurse Practitioner | 10151 Deerwood Park Blvd Ste 200-250, Jacksonville, FL 32256-0589 | 2013-07-02 |
| 1275885303 | Deborah Ann Davis | Nurse Practitioner | 10151 Deerwood Park Blvd Ste 200-250, Jacksonville, FL 32256-0589 | 2012-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
| 1093327702 | Oaktree Dental LLC | Clinic/Center | 14595 Philips Highway, Jacksonville, FL 32256 | 2020-08-24 |
| 1538787866 | Tywanna Council | Massage Therapist | 4720 Salisbury Road #102, Jacksonville, FL 32256 | 2020-07-13 |
| 1275155368 | Christy Orellana | Social Worker | 5011 Gate Parkway Bldg 100 Suite 100, Jacksonville, FL 32256 | 2020-05-11 |
| 1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
| 1982235859 | Sandra Josefina Baez Nunez | Nurse Practitioner | 10739 Deerwood Park Blvd, Suite 200, Jacksonville, FL 32256 | 2020-01-30 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1003472499 | Dade Medical, Inc. | Durable Medical Equipment & Medical Supplies | 9143 Philips Highway Suite 270, Jacksonville, FL 32256 | 2019-05-13 |
| 1003479726 | Nichole Bashara | Behavior Technician | 8383 Baymeadows Rd, Jacksonville, FL 32256 | 2019-04-18 |
| Find all providers in zip 32256 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748193 | Sophia Venditti | Social Worker | 2598 Post St # 1, Jacksonville, FL 32204-4256 | 2020-10-22 |
| 1629676093 | My Journey, LLC | Social Worker | 13453 N Main St Ste 204, Jacksonville, FL 32218-2773 | 2020-10-16 |
| 1104423524 | Sonya Young | Social Worker | 920 Bridier St, Jacksonville, FL 32206-5904 | 2020-10-08 |
| 1043823115 | Sierra Lashonda Murray | Social Worker | 9246 Thunderbolt Dr, Jacksonville, FL 32221-8052 | 2020-08-28 |
| 1235741901 | Deidra Lewis | Social Worker | 4480 Deerwood Lake Pkwy Unit 134, Jacksonville, FL 32216-2255 | 2020-08-23 |
| 1497365456 | Darlene Denise Rolle- Cargill | Social Worker | 14050 Integra Dr Apt 420, Jacksonville, FL 32218-2592 | 2020-08-05 |
| 1689282626 | Andrea Kristin Perkinson | Social Worker | 128 Plow Point Ln, Jacksonville, NC 28546-9591 | 2020-07-15 |
| 1255956371 | Noel Roman | Social Worker | 11775 Carson Lake Dr W, Jacksonville, FL 32221-3812 | 2020-06-15 |
| 1285257535 | Phaith Coaching & Counseling, LLC | Social Worker | 4940 Emerson St, Jacksonville, FL 32207-4963 | 2020-05-21 |
| 1407478613 | Mara's Lighthouse Counseling Center, LLC | Social Worker | 6015 Morrow St E Ste 114, Jacksonville, FL 32217-2125 | 2020-05-11 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32256 |
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| 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.