Active NPI
Angelica Witherspoon
- Mental Health Counselor
- Jacksonville, FL
National Provider Identifier
1215612718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH26767
- Practice address
- 820 Prudential Dr Ste 510
Jacksonville, FL 32207-8207 - Phone
- (904) 376-3800
- NPI assigned
- Jun 21, 2023
- Last updated
- Oct 30, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH26767 | FL | Primary |
Addresses
Primary practice location
820 Prudential Dr Ste 510
Jacksonville, FL 32207-8207
Mailing address
PO Box 748519
Atlanta, GA 30374-8519
Phone (904) 376-3800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
820 Prudential Dr
Suite 510
Jacksonville, FL 32207-8207
Phone (904) 376-3800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH26767 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Behavioral Health, LLC | Mental Health | Current | Accepting new patients |
Locations
820 Prudential Dr
Ste 510
Jacksonville, FL 32207
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761782400000",
"number": "1215612718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 748519",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303748519",
"telephone_number": "904-376-3800",
"fax_number": "904-376-3998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 PRUDENTIAL DR STE 510",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078207",
"telephone_number": "904-376-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITHERSPOON",
"first_name": "ANGELICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-21",
"last_updated": "2025-10-30",
"certification_date": "2025-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH26767",
"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 Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.