Individual provider Active NPI

Alisha Janae Gamble, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1356961791
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH17981 Issued in FL
Practice address
1301 Riverplace Blvd Ste 800
Jacksonville, FL 32207-9032
Phone
(904) 690-3900
Fax
(904) 690-3930
NPI assigned
Apr 24, 2020
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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 MH17981 FL Primary

Addresses

Primary practice location

1301 Riverplace Blvd Ste 800
Jacksonville, FL 32207-9032

Mailing address

1301 Riverplace Blvd Ste 800
Jacksonville, FL 32207-9032
Phone (904) 690-3900

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
MH17981FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1356961791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 RIVERPLACE BLVD STE 800",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079032",
            "telephone_number": "904-690-3900",
            "fax_number": "904-690-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 RIVERPLACE BLVD STE 800",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079032",
            "telephone_number": "904-690-3900",
            "fax_number": "904-690-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "ALISHA",
        "middle_name": "JANAE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-24",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17981",
            "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 3, 2023; 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.