Organization Active NPI

Connected Counselor LLC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1235595380
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH7665 Issued in FL
Legal business name
CONNECTED COUNSELOR LLC
Practice address
4540 Southside Blvd Ste 604
Jacksonville, FL 32216-5488
Phone
(904) 299-2928
Fax
(904) 800-1331
NPI assigned
Jan 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Authorized official

Name
Allison TegerNPI 1215180831
Title
Owner
Phone
(904) 299-2928

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MH7665 FL Primary

Addresses

Primary practice location

4540 Southside Blvd Ste 604
Jacksonville, FL 32216-5488

Mailing address

4540 Southside Blvd Ste 604
Jacksonville, FL 32216-5488
Phone (904) 299-2928

National Provider Directory

National Provider Directory

Locations

4540 Southside Blvd
Ste 604
Jacksonville, FL 32216
Phone (904) 299-2928

8825 Perimeter Park Blvd
Ste 302
Jacksonville, FL 32216
Phone (904) 250-0088

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1235595380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 SOUTHSIDE BLVD STE 604",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165488",
            "telephone_number": "904-299-2928",
            "fax_number": "904-800-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 SOUTHSIDE BLVD STE 604",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165488",
            "telephone_number": "904-299-2928",
            "fax_number": "904-800-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTED COUNSELOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-05",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "TEGER",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-299-2928"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH7665",
            "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 Jul 25, 2019; 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.