Individual provider Active NPI

Brynda J McClendon

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1326396011
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2392 Edgewood Ave N
Jacksonville, FL 32254-1725
Phone
(904) 781-0600
Fax
(904) 781-0016
NPI assigned
Aug 28, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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 Primary

Addresses

Primary practice location

2392 Edgewood Ave N
Jacksonville, FL 32254-1725

Mailing address

7864 Mattox Ave
Jacksonville, FL 32219-3124
Phone (904) 781-0600

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": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1326396011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7864 MATTOX AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322193124",
            "telephone_number": "904-781-0600",
            "fax_number": "904-781-0016"
        },
        {
            "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": "904-781-0600",
            "fax_number": "904-781-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENDON",
        "first_name": "BRYNDA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "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 28, 2012; 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.