Organization Active NPI

Trauma Healing Center, LLC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1437674769
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH13530 Issued in FL
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

Updated by the provider on Jul 21, 2022

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)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MH13530 FL Primary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.