Individual provider Active NPI

Kalima Thema Jackson Wills, LMHC

  • Mental Health Counselor
  • Winter Garden, FL
National Provider Identifier
1003349945
Registry record updated Oct 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH20122 Issued in FL
Practice address
6725 Marmalade Aly
Winter Garden, FL 34787-5083
Phone
(407) 986-1046
Fax
(689) 348-7003
NPI assigned
Apr 7, 2017
Last updated
Oct 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH20122 FL Primary
Mental Health Counselor 101YM0800X LH61469671 WA

Addresses

Primary practice location

6725 Marmalade Aly
Winter Garden, FL 34787-5083

Mailing address

2212 S Chickasaw TRL Ste 1069
Orlando, FL 32825-8414
Phone (407) 986-1046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Mental Health and Wellness LLC Mental Health Current Accepting new patients
Uplift Behavioral Health PC Past Accepting new patients

Locations

2212 S Chickasaw Trl
Orlando, FL 32825
Phone (330) 573-3951

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792108800000",
    "number": "1003349945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 S CHICKASAW TRL STE 1069",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328258414",
            "telephone_number": "407-986-1046",
            "fax_number": "689-348-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6725 MARMALADE ALY",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875083",
            "telephone_number": "407-986-1046",
            "fax_number": "689-348-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON WILLS",
        "first_name": "KALIMA",
        "middle_name": "THEMA",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-07",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH20122",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61469671",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.