Individual provider Active NPI

Danielle Farra Bingham, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1275928798
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH16896 Issued in FL
Practice address
12058 San Jose Blvd Ste 104
Jacksonville, FL 32223-8669
Phone
(352) 217-6200
NPI assigned
Apr 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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 MH16896 FL Primary

Addresses

Primary practice location

12058 San Jose Blvd Ste 104
Jacksonville, FL 32223-8669

Mailing address

15025 Durbin Cove Way
Jacksonville, FL 32259-7041
Phone (352) 217-6200

Other practice location 1

4595 Lexington Ave
Jacksonville, FL 32210-2058
Phone (904) 448-4700 ext. 513

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
I20240419002050 FL Practitioner - Mental Health Counselor 4183063316 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH16896FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Castle Inc. CurrentSince Jan 15, 2024 Accepting new patients
Clay Physical Therapy PA PastSince Jan 15, 2024 Accepting new patients

Locations

4911 Spring Park Rd
Jacksonville, FL 32207
Phone (904) 269-7751

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1275928798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15025 DURBIN COVE WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322597041",
            "telephone_number": "352-217-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12058 SAN JOSE BLVD STE 104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238669",
            "telephone_number": "352-217-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4595 Lexington Ave",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322102058",
            "country_code": "US",
            "telephone_number": "904-448-4700 x513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BINGHAM",
        "first_name": "DANIELLE",
        "middle_name": "FARRA",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.