Ashleigh Jane Mack, REGISTERED INTERN

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMT3884 Issued in FL

Practice address

162 Bradford Lake Cir
Jacksonville, FL 32218-0102

Phone

(743) 214-9472

NPI assigned

Apr 26, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Thriveworks Clinical - Florida Inc

  • Mental Health Counselor
  • Fort Lauderdale, FL
  • NPI 1396360996
  Medicare reassignment

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1285322404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 W MOREHEAD ST",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273203872",
            "telephone_number": "336-908-3927",
            "fax_number": "336-860-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 BRADFORD LAKE CIR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322180102",
            "telephone_number": "743-214-9472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "ASHLEIGH",
        "middle_name": "JANE",
        "credential": "REGISTERED INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "IMT3884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria C Machado
• Amy Caroline Macharg, LCSW
• Julia Maciel
• Kelsey Macieunas, CCC-SLP
• Marcell Virginia Mack-Hamilton, PHARMACIST
• Bruce Mack
• Crystal Mack, MASSAGE THERAPIST
• Elizabeth Mack
• Jilltorra Mack
• Letara Reyona Mack

• Marriage & Family Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.