Jacqueline Ivey

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

22951 Issued in FL

Practice address

2511 Saint Johns Bluff Rd S Ste 106
Jacksonville, FL 32246-2344

Phone

(410) 456-4294

NPI assigned

Nov 22, 2023

Sex

Female

Sole proprietor

Yes

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

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Breakthroughs Counseling and Recovery IncGroup PAC ID 6305063678, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Breakthroughs Counseling & Recovery

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1033133616

  Mental Health

  Medicare reassignment Care Compare group NPD
• Breakthroughs Counseling and Recovery Inc.

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1568861516
  NPD (past)

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

{
    "created_epoch": "1700611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1285409920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 SHETTER AVE APT 6109",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503458",
            "telephone_number": "410-456-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 SAINT JOHNS BLUFF RD S STE 106",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322462344",
            "telephone_number": "410-456-4294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVEY",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-22",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "22951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rommy Issa, M.D.
• Amihan Noelle Culi Iszler, DPT
• Its Holistic Therapy LLC
• Ivan Guerrero MD PA
• Alina Ivaniuk, MD
• Karon Irene Ivey, LMHC
• Petronia D Ivey
• Walter Warren Ivey III, AU.D
• Lisbet Ivicic, NP
• Agnieszka Teresa Ivins

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, 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 Nov 22, 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.