Surrendering Minds LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

SURRENDERING MINDS LLC

Practice address

11627 Hickory Oak Dr
Jacksonville, FL 32218-9078

Phone

(904) 316-4420

NPI assigned

Apr 21, 2018

Last updated

Apr 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lauren Anthony, LCSWNPI 1245622323

Title

MGR

Phone

(904) 316-4420

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lauren Anthony, LCSW

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1245622323
  NPD (past) Authorized official

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

{
    "created_epoch": "1524268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524268800000",
    "number": "1144717497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11627 HICKORY OAK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322189078",
            "telephone_number": "904-316-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11627 HICKORY OAK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322189078",
            "telephone_number": "904-316-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURRENDERING MINDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-21",
        "last_updated": "2018-04-21",
        "status": "A",
        "authorized_official_last_name": "ANTHONY",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "904-316-4420",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245622323",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Early Intervention Provider Agency in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Early Intervention Provider Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.