Individual provider Active NPI

Stacey Anne Farina, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1013774397
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH27282 Issued in FL
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

Updated by the provider on May 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
MH27282FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Shukrana LLC CurrentSince Mar 12, 2024 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.

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.

Verify at the official NPI Registry.