NPIMap

Organization Active NPI

Jacksonville Autism Clinic LLC

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1265016927
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
JACKSONVILLE AUTISM CLINIC LLC
Practice address
9000 Southside Blvd BLDG 900
Jacksonville, FL 32256-0791
Phone
(904) 732-4343
NPI assigned
May 10, 2021
Last updated
Jan 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Mrs. Helen Michelle Dunham
Title
Executive Director
Phone
(904) 732-4343

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X NU
Behavior Analyst 103K00000X NU

Addresses

Primary practice location

9000 Southside Blvd BLDG 900
Jacksonville, FL 32256-0791

Mailing address

9000 Southside Blvd BLDG 900
Jacksonville, FL 32256-0791
Phone (904) 732-4343

National Provider Directory

National Provider Directory

Locations

9000 Southside Blvd
Unit 900
Jacksonville, FL 32256
Phone (904) 732-4343

Practitioners & affiliated clinicians

Practitioners 61

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1265016927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 SOUTHSIDE BLVD BLDG 900",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560791",
            "telephone_number": "904-732-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 SOUTHSIDE BLVD BLDG 900",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560791",
            "telephone_number": "904-732-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE AUTISM CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-10",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "DUNHAM",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "904-732-4343",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Jan 16, 2025; 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.