Active NPI
Modern Therapy & Counseling, LLC
- Mental Health Counselor
- Saint Augustine, FL
National Provider Identifier
1083169478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH14185
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. January L Turner, MA, LMHC
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 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 DirectoryLocations
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.
-
- Mental Health Counselor
- Saint Augustine, FL
- NPI 1295188092
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.