Individual provider Active NPI

Jamila Rashel Tippit

  • Mental Health Counselor
  • Riverview, FL
National Provider Identifier
1285326942
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMT3883 Issued in FL
Practice address
11912 Balm Riverview Rd
Riverview, FL 33569-6601
Phone
(813) 444-7116
NPI assigned
May 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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 IMT3883 FL Primary

Addresses

Primary practice location

11912 Balm Riverview Rd
Riverview, FL 33569-6601

Mailing address

11912 Balm Riverview Rd
Riverview, FL 33569-6601
Phone (813) 444-7116

Other practice location 1

2911 Park Pond Way
Kissimmee, FL 34741-7661
Phone (813) 444-7116

Other practice location 2

255 N Kentucky Ave Ste 204
Lakeland, FL 33801-4981
Phone (863) 904-1541

Other practice location 3

29160 Chapel Park Dr
Wesley Chapel, FL 33543-4404
Phone (813) 444-7116

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

State licenses

LicenseStateTypeSpecialty
IMT3883FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Garden, LLC Current Accepting new patients
Renewed Integrative Counseling Mental Health CurrentSince May 28, 2023 Accepting new patients

Locations

2911 Park Pond Way
Kissimmee, FL 34741
Phone (813) 444-7116

11912 Balm Riverview Rd
Riverview, FL 33569
Phone (813) 444-7116

29160 Chapel Park Dr
Wesley Chapel, FL 33543
Phone (813) 444-7116

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": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1285326942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11912 BALM RIVERVIEW RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335696601",
            "telephone_number": "813-444-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11912 BALM RIVERVIEW RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335696601",
            "telephone_number": "813-444-7116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2911 Park Pond Way",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347417661",
            "country_code": "US",
            "telephone_number": "813-444-7116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "255 N Kentucky Ave Ste 204",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338014981",
            "country_code": "US",
            "telephone_number": "863-904-1541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29160 Chapel Park Dr",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335434404",
            "country_code": "US",
            "telephone_number": "813-444-7116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIPPIT",
        "first_name": "JAMILA",
        "middle_name": "RASHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMT3883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.