Active NPI
Jennifer A Butler, LMHC
- Mental Health Counselor
- Jacksonville, FL
National Provider Identifier
1124654967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH17149
- Practice address
- 820 Prudential Dr Ste 510
Jacksonville, FL 32207-8207 - Phone
- (904) 376-3800
- Fax
- (904) 396-8971
- NPI assigned
- Mar 12, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH17149 | FL | Primary |
Addresses
Primary practice location
820 Prudential Dr Ste 510
Jacksonville, FL 32207-8207
Mailing address
PO Box 44230
Jacksonville, FL 32231-4230
Phone (904) 376-3800
Other names 1
- Jennifer A McDermott
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH17149 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Behavioral Health, LLC | Mental Health | Current | Accepting new patients |
Locations
820 Prudential Dr
Ste 510
Jacksonville, FL 32207
Organizations & group practices 1
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": "1583971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583971200000",
"number": "1124654967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 44230",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322314230",
"telephone_number": "904-376-3800",
"fax_number": "904-391-5394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 PRUDENTIAL DR STE 510",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078207",
"telephone_number": "904-376-3800",
"fax_number": "904-396-8971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "JENNIFER",
"middle_name": "A",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-12",
"last_updated": "2020-03-12",
"certification_date": "2020-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH17149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "MCDERMOTT",
"middle_name": "A",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.