Active NPI
Cynthia C. Wingate, PCMHT
- Mental Health Counselor
- Jacksonville, FL
National Provider Identifier
1174841142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH 10161
- Practice address
- 2912 Saint Johns Ave Apt 1a
Jacksonville, FL 32205-8725 - Phone
- (772) 205-0432
- Fax
- (561) 516-6211
- NPI assigned
- May 14, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | PC-0000817 | DE | |
| Mental Health Counselor | 101YM0800X | MH 10161 | FL | Primary |
Addresses
Primary practice location
2912 Saint Johns Ave Apt 1a
Jacksonville, FL 32205-8725
Mailing address
2912 Saint Johns Ave Apt 1a
Jacksonville, FL 32205-8725
Phone (772) 205-0432
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC-0000817 | DE | MD | Mental Health Counselor |
| MH 10161 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654560000000",
"number": "1174841142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2912 SAINT JOHNS AVE APT 1A",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322058725",
"telephone_number": "772-205-0432",
"fax_number": "561-516-6211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2912 SAINT JOHNS AVE APT 1A",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322058725",
"telephone_number": "772-205-0432",
"fax_number": "561-516-6211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINGATE",
"first_name": "CYNTHIA",
"middle_name": "C.",
"credential": "PCMHT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-14",
"last_updated": "2022-06-07",
"certification_date": "2022-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "DE",
"license": "PC-0000817",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH 10161",
"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 Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.