Individual provider Active NPI

Barika Grayson, LMHC, NCC, CCM

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1053579789
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH9952 Issued in FL
Practice address
7235 Bentley Rd Ste 106
Jacksonville, FL 32256-7506
Phone
(904) 413-1379
Fax
(904) 677-7886
NPI assigned
May 29, 2008
Last updated
Feb 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Mental Health Counselor 101YM0800X MH9952 FL Primary
Professional Counselor 101YP2500X MH9952 FL
Case Manager/Care Coordinator 171M00000X 4210365 NU

Addresses

Primary practice location

7235 Bentley Rd Ste 106
Jacksonville, FL 32256-7506

Mailing address

7235 Bentley Rd Ste 106
Jacksonville, FL 32256-7506
Phone (904) 413-1379

Other identifiers 1

IdentifierTypeStateIssuer
006491400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240315000149 FL Practitioner - Mental Health Counselor 6406147578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7235 Bentley Rd
Suite 106
Jacksonville, FL 32256-7506

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Concierge & Vip Counseling LLC Counselor CurrentSince Jan 21, 2024 Accepting new patients

Locations

7235 Bentley Rd
Ste 106
Jacksonville, FL 32256
Phone (904) 413-1379

8130 Baymeadows Way W
Ste 102
Jacksonville, FL 32256
Phone (904) 737-3232

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": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1053579789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7235 BENTLEY RD STE 106",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567506",
            "telephone_number": "904-413-1379",
            "fax_number": "904-677-7886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7235 BENTLEY RD STE 106",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567506",
            "telephone_number": "904-413-1379",
            "fax_number": "904-677-7886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYSON",
        "first_name": "BARIKA",
        "credential": "LMHC, NCC, CCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9952",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH9952",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": "4210365",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006491400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.