Individual provider Active NPI

Cedric Singletary, IMH,MCAP, ICADC

  • Case Manager/Care Coordinator
  • Jacksonville, FL
National Provider Identifier
1154742070
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
CBHCMS100798 Issued in FL
Practice address
3636 University Blvd S Ste A9
Jacksonville, FL 32216-4209
Phone
(904) 551-4953
Fax
(904) 683-5678
NPI assigned
Dec 19, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X CBHCMS100798 FL Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 5444 FL
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X MCAP100381 FL
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X IMH20336 FL

Addresses

Primary practice location

3636 University Blvd S Ste A9
Jacksonville, FL 32216-4209

Mailing address

11109 Stirling CT
Jacksonville, FL 32221-3926
Phone (904) 329-0024

Other identifiers 1

IdentifierTypeStateIssuer
1063800100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5444FLMDAddiction (Substance Use Disorder) Counselor
MCAP100381FLMDAddiction (Substance Use Disorder) Counselor
IMH20336FLMDMental Health Counselor
CBHCMS100798FLMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Saves Multi-Specialty CurrentSince Nov 3, 2024 Accepting new patients
New Life Counseling and Educational Services Addiction (Substance Use Disorder) CurrentSince Mar 28, 2021 Accepting new patients
New Life Counseling and Educational Services Current Accepting new patients

Locations

6411 Arlington Rd
Ste 1
Jacksonville, FL 32211
Phone (904) 329-0024

4124 Boulevard Center Dr
Jacksonville, FL 32207

3636 University Blvd S
Ste A9
Jacksonville, FL 32216
Phone (904) 551-4953

Organizations & group practices 3

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": "1387411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1154742070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 STIRLING CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322213926",
            "telephone_number": "904-329-0024",
            "fax_number": "904-683-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 UNIVERSITY BLVD S STE A9",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164209",
            "telephone_number": "904-551-4953",
            "fax_number": "904-683-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINGLETARY",
        "first_name": "CEDRIC",
        "name_prefix": "Mr.",
        "credential": "IMH,MCAP, ICADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-19",
        "last_updated": "2021-03-24",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "CBHCMS100798",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "5444",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "MCAP100381",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH20336",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063800100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.