Phyllis Ingram, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH004028 Issued in FL

Practice address

3107 Sawgrass Village Cir
Ponte Vedra Beach, FL 32082-5032

Phone

(904) 373-0942

NPI assigned

Nov 18, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• A & B Counseling LLC

  • In Home Supportive Care Agency
  • Fort Lauderdale, FL
  • NPI 1316400203
  NPD (past)

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1083371611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 SAWGRASS VILLAGE CIR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320825032",
            "telephone_number": "904-373-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 SAWGRASS VILLAGE CIR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320825032",
            "telephone_number": "904-373-0942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "PHYLLIS",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH004028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Huber, D.C.
• Jennifer Lynn Hunsader, O.D.
• Vallery F Huston
• Kai Elizabeth Hutson, LMHC
• Vivien Huynh, APRN
• Innovative Therapy Solutions Inc
• Integrated Therapy of FL LLC
• Integrative Medical Group, USA, LLC
• Naomi Jacobs, PH.D.
• Ashley Marie Jacoby, LMHC

• Mental Health Counselor in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.