Active NPI
Trauma Healing Center, LLC
- Mental Health Counselor
- Jacksonville, FL
National Provider Identifier
1437674769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH13530
- Legal business name
- TRAUMA HEALING CENTER, LLC
- Practice address
- 8825 Perimeter Park Blvd Ste 402
Jacksonville, FL 32216-1124 - Phone
- (904) 719-3312
- NPI assigned
- Aug 8, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Zachary Fleming
- Title
- Director
- Phone
- (904) 894-1736
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH13530 | FL | Primary |
| Emergency Medicine Physician | 207P00000X | ME102872 | FL |
Addresses
Primary practice location
8825 Perimeter Park Blvd Ste 402
Jacksonville, FL 32216-1124
Mailing address
8825 Perimeter Park Blvd Ste 402
Jacksonville, FL 32216-1124
Phone (904) 719-3312
National Provider Directory
National Provider DirectoryLocations
8825 Perimeter Park Blvd
Ste 402
Jacksonville, FL 32216
Phone (904) 647-6238
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502150400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1437674769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8825 PERIMETER PARK BLVD STE 402",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322161124",
"telephone_number": "904-719-3312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8825 PERIMETER PARK BLVD STE 402",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322161124",
"telephone_number": "904-719-3312"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRAUMA HEALING CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-08-08",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "FLEMING",
"authorized_official_first_name": "ZACHARY",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "904-894-1736"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH13530",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": "FL",
"license": "ME102872",
"primary": false
}
],
"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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.