Individual provider Active NPI

David Lee

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1396298923
Registry record updated Aug 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH7710 Issued in FL
Practice address
1301 Riverplace Blvd Ste 800
Jacksonville, FL 32207-9032
Phone
(904) 562-1391
Fax
(904) 562-1361
NPI assigned
Aug 1, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2016

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 MH7710 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) 562-1391

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
MH7710FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Behavioral Services LLC Mental Health PastSince Aug 23, 2017 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470009600000",
    "number": "1396298923",
    "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": "904-562-1391",
            "fax_number": "904-562-1361"
        },
        {
            "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": "904-562-1391",
            "fax_number": "904-562-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-01",
        "last_updated": "2016-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH7710",
            "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 Aug 1, 2016; 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.