Individual provider Active NPI

Ashley Mollema

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1093182917
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3027 San Diego Rd
Jacksonville, FL 32207-3691
Phone
(904) 493-7744
NPI assigned
Aug 26, 2015
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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 Primary

Addresses

Primary practice location

3027 San Diego Rd
Jacksonville, FL 32207-3691

Mailing address

3027 San Diego Rd
Jacksonville, FL 32207-3691

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240422000901 DC Practitioner - Mental Health Counselor 0143669358 Reassigns benefits to 3 organizations
I20240426001462 VA Practitioner - Mental Health Counselor 0143669358 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Womens Center CurrentSince Jun 6, 2025 Accepting new patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Inova Health Care Services CurrentSince Feb 28, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jul 1, 2024 Accepting new patients
Inova Health Care Services CurrentSince Feb 28, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

8505 Arlington Blvd
Ste 200
Fairfax, VA 22031
Phone (703) 698-8525

19 Fort Evans Rd NE
Ste C
Leesburg, VA 20176
Phone (703) 737-2110

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

8230 Old Courthouse Rd
Ste 500
Vienna, VA 22182
Phone (571) 385-0903

Interoperability endpoints

  • Direct secure messaging: ashleymollema@tdh.allscriptsdirect.net

Organizations & group practices 7

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": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1093182917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3027 SAN DIEGO RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3027 SAN DIEGO RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073691",
            "telephone_number": "904-493-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLEMA",
        "first_name": "ASHLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-26",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3027 San Diego Rd",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322073691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.