Authentically You, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MH13243 Issued in FL

Legal business name

AUTHENTICALLY YOU, LLC

Practice address

109 Nature Walk Pkwy Unit 104
Saint Augustine, FL 32092-5065

Phone

(904) 629-1565

Fax

(904) 562-3465

NPI assigned

Oct 20, 2017

Organization subpart

No

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

Authorized official

Name

Amanda Payne, LMHCNPI 1205287661

Title

Owner

Phone

(904) 629-1565

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Payne, LMHC

  • Mental Health Counselor
  • St Augustine, FL
  • NPI 1205287661
  NPD (past) Authorized official

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552348800000",
    "number": "1326559097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 NATURE WALK PKWY UNIT 104",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320925065",
            "telephone_number": "904-629-1565",
            "fax_number": "904-562-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 NATURE WALK PKWY UNIT 104",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320925065",
            "telephone_number": "904-629-1565",
            "fax_number": "904-562-3465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Market St Ste 103B",
            "address_purpose": "LOCATION",
            "city": "Saint Augustine",
            "state": "FL",
            "postal_code": "320958803",
            "country_code": "US",
            "telephone_number": "904-629-1565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AUTHENTICALLY YOU, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-20",
        "last_updated": "2019-03-12",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-629-1565",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "MH13243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Rahner Augustine
• John C Augustus Jr.
• Jade Austad, PT, DPT
• James Ryland Austin, PT,DPT,MTC
• Makenzie Austin
• Autopap Sales and Rental (Complete Driver Sleep Program)
• Avanti Wellness Center Flllp
• Avanti Wellness Center Flllp
• Avanti Wellness Center Flllp (Avanti Wellness Center)
• Avanti Wellness Center Inc

• Community/Behavioral Health Agency in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.