Individual provider Active NPI

Sara Ann Allen

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1346911633
Registry record updated Sep 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
19266 Issued in FL
Practice address
13500 Sutton Park Dr S
Jacksonville, FL 32224-5251
Phone
(904) 735-8730
NPI assigned
Sep 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2021

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 19266 FL Primary

Addresses

Primary practice location

13500 Sutton Park Dr S
Jacksonville, FL 32224-5251

Mailing address

3548 Pintail Dr S
Jacksonville Beach, FL 32250-3042
Phone (904) 866-6082

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
19266FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1632614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632614400000",
    "number": "1346911633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3548 PINTAIL DR S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503042",
            "telephone_number": "904-866-6082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13500 SUTTON PARK DR S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322245251",
            "telephone_number": "904-735-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "SARA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-26",
        "last_updated": "2021-09-26",
        "certification_date": "2021-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "19266",
            "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 Sep 26, 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.