Active NPI
Shaunetra Andrews
- Mental Health Counselor
- Jacksonville, FL
National Provider Identifier
1285294801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2392 Edgewood Ave N
Jacksonville, FL 32254-1725 - Phone
- (904) 781-7797
- NPI assigned
- Jun 17, 2019
- Last updated
- Jun 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2392 Edgewood Ave N
Jacksonville, FL 32254-1725
Mailing address
1216 Turtle Creek Dr S
Jacksonville, FL 32218-3653
Phone (904) 708-4407
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | . |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560729600000",
"number": "1285294801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1216 TURTLE CREEK DR S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322183653",
"telephone_number": "904-708-4407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2392 EDGEWOOD AVE N",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322541725",
"telephone_number": "904-781-7797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDREWS",
"first_name": "SHAUNETRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-17",
"last_updated": "2019-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": ".",
"affiliation": "N",
"address_1": "2392 Edgewood Ave N",
"city": "Jacksonville",
"state": "FL",
"country_code": "US",
"postal_code": "322541725",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jun 17, 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.