Individual provider Active NPI

Carrie Ann Brown, M.A.

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1235437708
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH 8364 Issued in FL
Practice address
1100 Cesery Blvd
Suite 11
Jacksonville, FL 32211-5674
Phone
(904) 745-3070
NPI assigned
Mar 8, 2011
Last updated
Mar 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

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 IMH 8364 FL Primary

Addresses

Primary practice location

1100 Cesery Blvd
Suite 11
Jacksonville, FL 32211-5674

Mailing address

10010 Skinner Lake Drive
Apartment 925
Jacksonville, FL 32246

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240522004219 FL Practitioner - Mental Health Counselor 3779925730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent's Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

1801 Barrs St
Suite 120
Jacksonville, FL 32204-4738
Phone (904) 308-2006

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
IMH 8364FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Jun 24, 2024 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Jun 24, 2024 Accepting new patients

Locations

2001 County Road 210 W
Ste 200
St Johns, FL 32259
Phone (904) 450-8120

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299542400000",
    "number": "1235437708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 SKINNER LAKE DRIVE",
            "address_2": "APARTMENT 925",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CESERY BLVD",
            "address_2": "SUITE 11",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322115674",
            "telephone_number": "904-745-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CARRIE",
        "middle_name": "ANN",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-08",
        "last_updated": "2011-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH 8364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.