Active NPI
Vernon Ricardo Washington, M.A.
- Mental Health Counselor
- St Augustine, FL
National Provider Identifier
1184969008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- IMH10523
- Practice address
- 67 S Dixie Hwy
St Augustine, FL 32084-0317 - Phone
- (904) 429-7573
- Fax
- (904) 547-2731
- NPI assigned
- Dec 4, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMH10523 | FL | Primary |
Addresses
Primary practice location
67 S Dixie Hwy
St Augustine, FL 32084-0317
Mailing address
67 S Dixie Hwy
St Augustine, FL 32084-0317
Phone (904) 429-7573
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMH10523 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Rehabilitation Center, Inc. | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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": "1354579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354579200000",
"number": "1184969008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 S DIXIE HWY",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320840317",
"telephone_number": "904-429-7573",
"fax_number": "904-547-2731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 S DIXIE HWY",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320840317",
"telephone_number": "904-429-7573",
"fax_number": "904-547-2731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASHINGTON",
"first_name": "VERNON",
"middle_name": "RICARDO",
"name_prefix": "Mr.",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-04",
"last_updated": "2012-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMH10523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.