Organization Active NPI

Embracing Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1184357923
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
EMBRACING BEHAVIORAL HEALTH
Practice address
12724 Gran Bay Pkwy W Ste 410
Jacksonville, FL 32258-9486
Phone
(904) 465-2407
NPI assigned
Jul 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Authorized official

Name
Carolyn Ann McClinton, DNP PMHNP-BC, FNP-CNPI 1407259476
Title
Manager/Pmhnp
Phone
(904) 710-8636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

12724 Gran Bay Pkwy W Ste 410
Jacksonville, FL 32258-9486

Mailing address

12724 Gran Bay Pkwy W Ste 410
Jacksonville, FL 32258-9486
Phone (904) 710-8636

Other identifiers 1

IdentifierTypeStateIssuer
013605400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220804001214 FL Part B Supplier - Clinic/Group Practice 2567844749 Receives reassigned benefits from 2 practitioners
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27157/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1184357923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12724 GRAN BAY PKWY W STE 410",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322589486",
            "telephone_number": "904-710-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12724 GRAN BAY PKWY W STE 410",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322589486",
            "telephone_number": "904-465-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBRACING BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-08",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "MCCLINTON",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MANAGER/PMHNP",
        "authorized_official_telephone_number": "904-710-8636",
        "authorized_official_credential": "DNP PMHNP-BC, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013605400",
            "state": "FL"
        }
    ],
    "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 May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.