Individual provider Active NPI

Jeannie Mitchell, LMHC

  • Mental Health Counselor
  • Fleming Island, FL
National Provider Identifier
1114348661
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH12193 Issued in FL
Practice address
4609 US Highway 17 Ste 1
Fleming Island, FL 32003-4818
Phone
(904) 375-2353
Fax
(904) 375-2349
NPI assigned
Jan 1, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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 MH12193 FL Primary

Addresses

Primary practice location

4609 US Highway 17 Ste 1
Fleming Island, FL 32003-4818

Mailing address

4609 US Highway 17 Ste 1
Fleming Island, FL 32003-4818
Phone (904) 375-2353

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
I20240116002651 FL Practitioner - Mental Health Counselor 8022460096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emdr Trauma Therapy Center LLC 5 clinicians

Practice addresses (Care Compare)

4609 US Hwy 17
Suite 1
Fleming Island, FL 32003

4609 US Hwy 17
Suite 1
Fleming Island, FL 32003-4818
Phone (904) 375-2353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH12193FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Emdr Trauma Therapy Center LLC Mental Health CurrentSince Aug 1, 2020 Accepting new patients
First Coast Psychiatric Services, P.a. PastSince Jun 3, 2018 Accepting new patients

Locations

4609 US Highway 17
Ste 1
Fleming Isle, FL 32003
Phone (904) 375-2353

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1388534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1114348661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 US HIGHWAY 17 STE 1",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034818",
            "telephone_number": "904-375-2353",
            "fax_number": "904-375-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 US HIGHWAY 17 STE 1",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034818",
            "telephone_number": "904-375-2353",
            "fax_number": "904-375-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JEANNIE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-01",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

Verify at the official NPI Registry.