Individual provider Active NPI

Mary Wihnyk, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1477127629
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH19221 Issued in FL
Practice address
12443 San Jose Blvd
Jacksonville, FL 32223-8646
Phone
(904) 383-7613
NPI assigned
May 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH19221 FL Primary

Addresses

Primary practice location

12443 San Jose Blvd
Jacksonville, FL 32223-8646

Mailing address

4505 Prunty Ave
Jacksonville, FL 32205-7148
Phone (352) 871-3313

Other practice location 1

1903 Island Walk Way
Fernandina Beach, FL 32034-4797
Phone (352) 871-3313

Other identifiers 1

IdentifierTypeStateIssuer
MH19221OtherFLLICENSURE NUMBER

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

State licenses

LicenseStateTypeSpecialty
MH19221FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1477127629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 PRUNTY AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322057148",
            "telephone_number": "352-871-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12443 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238646",
            "telephone_number": "904-383-7613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1903 Island Walk Way",
            "address_purpose": "LOCATION",
            "city": "Fernandina Beach",
            "state": "FL",
            "postal_code": "320344797",
            "country_code": "US",
            "telephone_number": "352-871-3313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIHNYK",
        "first_name": "MARY",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH19221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE NUMBER",
            "identifier": "MH19221",
            "state": "FL"
        }
    ],
    "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 13, 2021; 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.