Organization Active NPI

Modern Therapy & Counseling, LLC

  • Mental Health Counselor
  • Saint Augustine, FL
National Provider Identifier
1083169478
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH14185 Issued in FL
Legal business name
MODERN THERAPY & COUNSELING, LLC
Practice address
88 Riberia St
Suite 150
Saint Augustine, FL 32084-3300
Phone
(904) 392-1505
NPI assigned
Aug 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Authorized official

Name
Mrs. January L Turner, MA, LMHCNPI 1295188092
Title
Licensed Mental Health Counselor
Phone
(904) 392-1505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MH14185 FL Primary

Addresses

Primary practice location

88 Riberia St
Suite 150
Saint Augustine, FL 32084-3300

Mailing address

4071 New Hampshire Rd
Elkton, FL 32033-2124
Phone (904) 392-1505

National Provider Directory

National Provider Directory

Locations

88 Riberia St
Ste 150
St Augustine, FL 32084
Phone (904) 201-9533

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471305600000",
    "number": "1083169478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4071 NEW HAMPSHIRE RD",
            "city": "ELKTON",
            "state": "FL",
            "postal_code": "320332124",
            "telephone_number": "904-392-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 RIBERIA ST",
            "address_2": "SUITE 150",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320843300",
            "telephone_number": "904-392-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN THERAPY & COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-08-16",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "JANUARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "LICENSED MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "904-392-1505",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH14185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; 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.