NPIMap

Organization Active NPI

Life Counseling Center, Inc.

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1447361035
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LIFE COUNSELING CENTER, INC.
Practice address
8825 Perimeter Park Blvd Ste 601
Jacksonville, FL 32216-1122
Phone
(904) 997-0195
Fax
(904) 997-0163
NPI assigned
Aug 31, 2006
Last updated
Jan 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Authorized official

Name
Amy Decker, LCSWNPI 1508907098
Title
Owner
Phone
(904) 997-0195

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

8825 Perimeter Park Blvd Ste 601
Jacksonville, FL 32216-1122

Mailing address

8825 Perimeter Park Blvd Ste 601
Jacksonville, FL 32216-1122
Phone (904) 997-0195

Other practice location 1

2384 Sadler Rd
Fernandina Beach, FL 32034-4555
Phone (904) 333-7068

National Provider Directory

National Provider Directory

Locations

2384 Sadler Rd
Fernandina Beach, FL 32034
Phone (904) 333-7068

498 Osceola Ave
Jacksonville, FL 32250

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643328000000",
    "number": "1447361035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8825 PERIMETER PARK BLVD STE 601",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161122",
            "telephone_number": "904-997-0195",
            "fax_number": "904-997-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8825 PERIMETER PARK BLVD STE 601",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161122",
            "telephone_number": "904-997-0195",
            "fax_number": "904-997-0163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2384 Sadler Rd",
            "address_purpose": "LOCATION",
            "city": "Fernandina Beach",
            "state": "FL",
            "postal_code": "320344555",
            "country_code": "US",
            "telephone_number": "904-333-7068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFE COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-997-0195",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "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 Jan 28, 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.