Individual provider Active NPI

Kathleen Dantas

  • Counseling Psychologist
  • Jacksonville, FL
National Provider Identifier
1437942331
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Practice address
12735 Gran Bay Pkwy W
Jacksonville, FL 32258-4492
Phone
(888) 754-0398
NPI assigned
May 23, 2025
Last updated
May 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X NU Primary

Addresses

Primary practice location

12735 Gran Bay Pkwy W
Jacksonville, FL 32258-4492

Mailing address

54 Pathway CT
Saint Johns, FL 32259-6322
Phone (904) 770-9937

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

NPI Registry JSON

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1437942331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 PATHWAY CT",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322596322",
            "telephone_number": "904-770-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12735 GRAN BAY PKWY W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322584492",
            "telephone_number": "888-754-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTAS",
        "first_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "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 May 23, 2025; 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.