Individual provider Active NPI

Ellen Baughman, LMFT

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1144821802
Registry record updated Nov 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MT3884 Issued in FL
Practice address
13500 Sutton Park Dr S Ste 702
Jacksonville, FL 32224-5290
Phone
(904) 247-2179
NPI assigned
Nov 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2020

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 MT3884 FL Primary

Addresses

Primary practice location

13500 Sutton Park Dr S Ste 702
Jacksonville, FL 32224-5290

Mailing address

878 Pleasure Bay Dr
Jacksonville, FL 32225-5673
Phone (904) 982-0455

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

LicenseStateTypeSpecialty
MT3884FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1604707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604707200000",
    "number": "1144821802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "878 PLEASURE BAY DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322255673",
            "telephone_number": "904-982-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13500 SUTTON PARK DR S STE 702",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322245290",
            "telephone_number": "904-247-2179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUGHMAN",
        "first_name": "ELLEN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-07",
        "last_updated": "2020-11-07",
        "certification_date": "2020-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MT3884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 7, 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.

Verify at the official NPI Registry.