Andrew Wallin, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH25200 Issued in FL

Practice address

3890 Dunn Ave
Jacksonville, FL 32218-6428

Phone

(904) 765-0665

NPI assigned

Mar 28, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Right Path Behavioral Health Services LLC

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1184925281
  Medicare reassignment
• Right Path Behavioral Health Services LLC

  • Community/Behavioral Health Agency
  • Orlando, FL
  • NPI 1417524976
  NPD
• Right Path Behavioral Health Services, LLC.

  • Community/Behavioral Health Agency
  • Ft Lauderdale, FL
  • NPI 1255139838
  NPD

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1134624596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9261 SW 24TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331658126",
            "telephone_number": "786-762-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 DUNN AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186428",
            "telephone_number": "904-765-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIN",
        "first_name": "ANDREW",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH25200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02790900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terrica Diane Wallace, PHARMD.
• Max Joseph Wallack
• Darci Waller
• John Waller
• Thomas Waller, MD
• Erica C Walling, PT
• Lucy A Walling, APRN
• Marissa Walling
• Fatah Abdul Wallizada, M.D.
• Alyssa Walls

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, 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 Mar 25, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.