Jacqueline Leigh (Preferred) Mathis, REGISTERED INTERN

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH27996 Issued in FL

Practice address

319 W Town PL Ste 21
St Augustine, FL 32092-3103

Phone

(904) 640-9099

NPI assigned

Apr 22, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1194512293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2872 N 1ST ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320841942",
            "telephone_number": "561-676-2529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 W TOWN PL STE 21",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923103",
            "telephone_number": "904-640-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "JACQUELINE",
        "middle_name": "LEIGH (PREFERRED)",
        "credential": "REGISTERED INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-22",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH27996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Nicolette Massey
• Allison A Masters, LMHC
• Cynthia K Mathena
• Alma Mather, APRN
• Matilda Mathias
• Randall T Mathis, PA-C
• Matrescence Method LLC
• Matrix Medical LLC
• Megan Elizabeth Matullo
• Maureen Cohen, Licensed Mental Health Counselor

• Mental Health Counselor in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.