Individual provider Active NPI

Rachel Patricia Wittosch, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1336758283
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH16838 Issued in FL
Practice address
2121 Corporate Square Blvd Ste 124
Jacksonville, FL 32216-1977
Phone
(904) 207-7973
NPI assigned
Jul 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X FL
Mental Health Counselor 101YM0800X MH16838 FL Primary

Addresses

Primary practice location

2121 Corporate Square Blvd Ste 124
Jacksonville, FL 32216-1977

Mailing address

2121 Corporate Square Blvd Ste 124
Jacksonville, FL 32216-1977

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
MH16838FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1336758283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 CORPORATE SQUARE BLVD STE 124",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 CORPORATE SQUARE BLVD STE 124",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161977",
            "telephone_number": "904-207-7973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTOSCH",
        "first_name": "RACHEL",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-27",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16838",
            "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 Oct 7, 2021; 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.