Sandra Jackson, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH8391 Issued in FL

Practice address

1880 San Sebastian VW Ste 4201
St Augustine, FL 32084-8684

Phone

(800) 539-4228

NPI assigned

Oct 18, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ms. Sandra Melchionne Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sandra.jackson.p1@direct.smahealthcare.nextgenshare.com

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

• Sma Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Daytona Beach, FL
  • NPI 1356329163
  Medicare reassignment NPD
• Sma Healthcare, Inc

  • Federally Qualified Health Center (FQHC)
  • Daytona Beach, FL
  • NPI 1255950168
  NPD
• Sma Healthcare Inc

  • Psychiatric Hospital
  • Daytona Beach, FL
  • NPI 1750369666
  NPD (past)

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1356330765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MAGNOLIA AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144304",
            "telephone_number": "800-539-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 SAN SEBASTIAN VW STE 4201",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320848684",
            "telephone_number": "800-539-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SANDRA",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8391",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH8391",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767122900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Z089A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "MELCHIONNE",
            "prefix": "MS.",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• J Mae Transportation
• Arlyn Rivera Jackson, MPT
• Deborah A Jackson, PHD,PT, OCS,CMP, ATC
• Julia Elaine Jackson
• Mark F Jackson, M.D.
• Jacksonville BH Services, LLC
• Jacksonville Orthopaedic Institute Inc
• Jacksonville Pediatrics World Golf Village PLLC
• Jacksonville Spine Center PA
• Jamie Frances Jacobsen, MOT

• Mental Health Counselor in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.