Emdr Trauma Therapy Center LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EMDR TRAUMA THERAPY CENTER LLC

Practice address

4609 US Highway 17 Ste 1
Fleming Island, FL 32003-4818

Phone

(904) 375-2353

Fax

(904) 375-2349

NPI assigned

Jul 10, 2020

Last updated

Jan 26, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jeannie L Mitchell, LMHCNPI 1114348661

Title

Principle/Owner

Phone

(904) 375-2353

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeannie Mitchell, LMHC

  • Mental Health Counselor
  • Fleming Island, FL
  • NPI 1114348661
  Medicare reassignment Care Compare group NPD Authorized official
• Rieko Higuchi, LMHC, CAP, CST

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1568418598
  Medicare reassignment Care Compare group NPD
• Dorothea Myles Jattan, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
  • NPI 1013753839
  Medicare reassignment Care Compare group NPD
• Cokey Yvonne Powell, PHD

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1194050997
  Medicare reassignment Care Compare group NPD
• Susan E Thyng

  • Professional Counselor
  • Morganton, NC
  • NPI 1437752078

  FL, Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769385600000",
    "number": "1407474943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 US HIGHWAY 17 STE 1",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034818",
            "telephone_number": "904-375-2353",
            "fax_number": "904-375-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 US HIGHWAY 17 STE 1",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034818",
            "telephone_number": "904-375-2353",
            "fax_number": "904-375-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMDR TRAUMA THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-10",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JEANNIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRINCIPLE/OWNER",
        "authorized_official_telephone_number": "904-375-2353",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1114348661",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.