Individual provider Active NPI

Adria Pratt Forte, LMHC

  • Counselor
  • Jacksonville, FL
National Provider Identifier
1285888073
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
MH 10386 Issued in FL
Practice address
6316 San Juan Ave
Suite 41
Jacksonville, FL 32210-2831
Phone
(904) 783-2579
Fax
(904) 225-1901
NPI assigned
Nov 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X MH 10386 FL Primary

Addresses

Primary practice location

6316 San Juan Ave
Suite 41
Jacksonville, FL 32210-2831

Mailing address

4320 Deerwood Lake Pkwy Ste 101-244
Jacksonville, FL 32216-1177
Phone (904) 716-6184

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
MH 10386FLMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Connections Unplugged Inc CurrentSince Aug 18, 2024 Accepting new patients

Locations

4320 Deerwood Lake Pkwy
Ste 101244
Jacksonville, FL 32216
Phone (904) 716-6184

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1285888073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 DEERWOOD LAKE PKWY STE 101-244",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161177",
            "telephone_number": "904-716-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6316 SAN JUAN AVE",
            "address_2": "SUITE 41",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102831",
            "telephone_number": "904-783-2579",
            "fax_number": "904-225-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTE",
        "first_name": "ADRIA",
        "middle_name": "PRATT",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2024-08-12",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH 10386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Aug 12, 2024; 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.