Individual provider Active NPI

Takiyah Joseph

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1447797493
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCSW16392 Issued in FL
Practice address
3725 Belfort Rd
Jacksonville, FL 32216-5813
Phone
(904) 296-1055
NPI assigned
Jan 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCSW16392 FL Primary
Social Worker 104100000X 081031 NY

Addresses

Primary practice location

3725 Belfort Rd
Jacksonville, FL 32216-5813

Mailing address

3725 Belfort Rd
Jacksonville, FL 32216-5813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240621001471 FL Practitioner - Clinical Social Worker 0244773067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acknowledge U Counseling and Consulting ServicesGroup PAC ID 9335682152, 2 clinicians

Practice addresses (Care Compare)

165 Wells Rd
Suite 401
Orange Park, FL 32073-3037
Phone (904) 370-3282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW16392FLMDMental Health Counselor
081031NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Acknowledge U Counseling & Consulting Services Mental Health CurrentSince Mar 20, 2024 Accepting new patients
Daniel Memorial Inc PastSince Nov 3, 2019 Accepting new patients
Daniel Memorial, Inc. PastSince Nov 3, 2019 Accepting new patients

Locations

165 Wells Rd
Ste 401
Orange Park, FL 32073
Phone (904) 370-3282

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1447797493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165813",
            "telephone_number": "904-296-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "TAKIYAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "LCSW16392",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "081031",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.