Individual provider Active NPI

Tonya Joy Douglas, LMHC

  • Mental Health Counselor
  • Macclenny, FL
National Provider Identifier
1376092957
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH11382 Issued in FL
Practice address
797 S 6TH St
Macclenny, FL 32063-9653
Phone
(904) 408-8883
Fax
(904) 259-1282
NPI assigned
Sep 24, 2016
Last updated
Apr 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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 MH11382 FL Primary

Addresses

Primary practice location

797 S 6TH St
Macclenny, FL 32063-9653

Mailing address

PO Box 896
Glen St Mary, FL 32040-0896
Phone (904) 408-8883

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260616003859 FL Practitioner - Mental Health Counselor 0345712782 Practice locations: Macclenny, FL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

797 S 6TH St
Macclenny, FL 32063-9653
Phone (904) 408-8883

99 Wall St
Suite 158
New York, NY 10005-4301

PO Box
Suite 896
Glen St Mary, FL 32040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH11382FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Axios Development & Investments, LLC Mental Health Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1474675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1376092957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 896",
            "city": "GLEN ST MARY",
            "state": "FL",
            "postal_code": "320400896",
            "telephone_number": "904-408-8883",
            "fax_number": "904-259-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "797 S 6TH ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320639653",
            "telephone_number": "904-408-8883",
            "fax_number": "904-259-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "TONYA",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-24",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macclenny, FL

Sources for this page

Verify at the official NPI Registry.