Dakota Ray Czerniak, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH18056 Issued in FL

Practice address

804 3Rd St
Neptune Beach, FL 32266-5040

Phone

(904) 801-9563

NPI assigned

Nov 29, 2021

Last updated

Nov 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1407513245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12603 ASHMORE GREEN DR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467239",
            "telephone_number": "407-467-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 3RD ST",
            "city": "NEPTUNE BEACH",
            "state": "FL",
            "postal_code": "322665040",
            "telephone_number": "904-801-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZERNIAK",
        "first_name": "DAKOTA",
        "middle_name": "RAY",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH18056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Neptune Beach, FL
• Providers in Neptune Beach, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.