Tonya Joy Douglas, LMHC
Individual provider Active NPI Mental Health Counselor · Macclenny, FL
NPI 1376092957 · NPPES record last updated Apr 24, 2026
Key facts
- NPI
- 1376092957
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- MH11382 (FL)
- Practice address
- 797 S 6TH St
Macclenny, FL 32063-9653 - Phone
- (904) 408-8883
- Fax
- (904) 259-1282
- NPI assigned
- Sep 24, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260616003859 | FL | Practitioner - Mental Health Counselor | 0345712782 | Practice locations: Macclenny, FL |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH11382 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Axios Development & Investments, LLC | Mental Health | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH11382 | FL | Yes |
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
Other providers in Macclenny, FL
- Brittany Nicole Day
- Felicia Diana Delgado
- Department of Children & Familes
- Ana L Dieng
- Catherine Dopson
- Justin Gary Dugger
- Toribio M Duhaylungsod
- Austin George Dupont
- Cheryl Dyer
- Robin Eaddy
All providers in Macclenny, FL · Mental Health Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.