Individual provider Active NPI

Antonio Marquel Jones, LMHC

  • Mental Health Counselor
  • Fort Pierce, FL
National Provider Identifier
1215543715
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH19605 Issued in FL
Practice address
130 S Indian River Dr Ste 202
Fort Pierce, FL 34950-4353
Phone
(772) 971-6118
Fax
(772) 905-4039
NPI assigned
Sep 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH19605 FL Primary

Addresses

Primary practice location

130 S Indian River Dr Ste 202
Fort Pierce, FL 34950-4353

Mailing address

1717 Orange Ave Unit 3373
Fort Pierce, FL 34948-2420
Phone (772) 971-6118

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

State licenses

LicenseStateTypeSpecialty
IMH19605FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1600560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1215543715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 ORANGE AVE UNIT 3373",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349482420",
            "telephone_number": "772-971-6118",
            "fax_number": "772-905-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S INDIAN RIVER DR STE 202",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504353",
            "telephone_number": "772-971-6118",
            "fax_number": "772-905-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "ANTONIO",
        "middle_name": "MARQUEL",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-20",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH19605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.