Active NPI
Stacey Anne Farina, LMHC
- Mental Health Counselor
- Jacksonville, FL
National Provider Identifier
1013774397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH27282
- Practice address
- 9310 Old Kings Rd S Ste 701
Jacksonville, FL 32257-6178 - Phone
- (904) 866-1857
- NPI assigned
- Mar 4, 2024
- Last updated
- May 19, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH27282 | FL | Primary |
Addresses
Primary practice location
9310 Old Kings Rd S Ste 701
Jacksonville, FL 32257-6178
Mailing address
9310 Old Kings Rd S Ste 701
Jacksonville, FL 32257-6178
Phone (904) 866-1857
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH27282 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shukrana LLC | Current | Accepting new patients |
Locations
1102 A1A N
Ste 203
Ponte Vedra Beach, FL 32082
Phone (904) 569-6875
Organizations & group practices 1
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": "1709510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779148800000",
"number": "1013774397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9310 OLD KINGS RD S STE 701",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322576178",
"telephone_number": "904-866-1857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9310 OLD KINGS RD S STE 701",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322576178",
"telephone_number": "904-866-1857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARINA",
"first_name": "STACEY",
"middle_name": "ANNE",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-04",
"last_updated": "2026-05-19",
"certification_date": "2026-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH27282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.