MTB Therapist, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

15468 Issued in FL

Legal business name

MTB THERAPIST, LLC

Practice address

6034 Chester Ave
Jacksonville, FL 32217-2264

Phone

(904) 323-2019

NPI assigned

Jan 27, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Merland Baker, LMHCNPI 1568804011

Title

Director

Phone

(904) 322-2162

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Merland Anthony Baker, M.S.

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1568804011
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1003314790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3452 LIVE OAK HOLLOW DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320652525",
            "fax_number": "904-323-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6034 CHESTER AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172264",
            "telephone_number": "904-323-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MTB THERAPIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-27",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "MERLAND",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-322-2162",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "FL",
            "license": "15468",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "15468",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "15468",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "15468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "261QM0801X - CLINIC/CENTER - MENTAL HEALTH (INCLUDING COMMUNITY MENTAL HEALTH CE",
            "identifier": "MH15468",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Professional Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.