Clay Community Counseling, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CLAY COMMUNITY COUNSELING, LLC

Practice address

2497 County Road 220
Middleburg, FL 32068-6531

Phone

(904) 801-5800

NPI assigned

Apr 16, 2020

Last updated

Apr 16, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Michelle Nicole Fiallo, LMHC, CCTP, MS

Title

Owner/Counselor

Phone

(904) 801-5800

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Ashley Ireland

  • Marriage & Family Therapist
  • Middleburg, FL
  • NPI 1952000325

  Mental Health

  NPD

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586995200000",
    "number": "1285254599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1763 COVINGTON LN",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320033387",
            "telephone_number": "703-731-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2497 COUNTY ROAD 220",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320686531",
            "telephone_number": "904-801-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY COMMUNITY COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-16",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A",
        "authorized_official_last_name": "FIALLO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/COUNSELOR",
        "authorized_official_telephone_number": "904-801-5800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHC, CCTP, MS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jo Cisco, LMHC
• Clay Behavioral Health Center Inc
• Clay Behavioral Health Center Inc
• Clay Behavioral Health Center Inc
• Clay Behavioral Health Center, Inc.
• Clay County Podiatry Associates PA
• Click Hear Now, LLC
• April Cobreiro, APRN
• Joel L Cohen, DO
• Christine M Coltrane, RN

• Mental Health Counselor in Middleburg, FL
• Providers in Middleburg, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; 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.