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
- 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 and National Provider Directory roles.
-
- Marriage & Family Therapist
- Ponte Vedra, FL
- NPI 1053018143
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.