Organization Active NPI

Hope and Healing Center, LLC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1477952364
Registry record updated Aug 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH12197 Issued in FL
Legal business name
HOPE AND HEALING CENTER, LLC
Practice address
6015 Morrow St E
Suite114
Jacksonville, FL 32217-2121
Phone
(800) 896-6105
Fax
(904) 637-4716
NPI assigned
Aug 18, 2014
Last updated
Aug 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2016

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

Authorized official

Name
Selma Zakomac Bacevac, LMHCNPI 1144505546
Title
Owner/Clinical Director
Phone
(800) 896-6105

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 Counselor 101YM0800X MH12197 FL Primary

Addresses

Primary practice location

6015 Morrow St E
Suite114
Jacksonville, FL 32217-2121

Mailing address

4411 Sunbeam Rd # 56918
Suite 101
Jacksonville, FL 32257-7525
Phone (800) 896-6105

Other identifiers 1

IdentifierTypeStateIssuer
010484600MedicaidFL

National Provider Directory

National Provider Directory

Locations

4411 Sunbeam Rd
Ste 101
Jacksonville, FL 32257

6015 Morrow St E
Ste 114
Jacksonville, FL 32217
Phone (800) 896-6105

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": "1408320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472428800000",
    "number": "1477952364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 SUNBEAM RD # 56918",
            "address_2": "SUITE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322577525",
            "telephone_number": "800-896-6105",
            "fax_number": "904-637-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 MORROW ST E",
            "address_2": "SUITE114",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172121",
            "telephone_number": "800-896-6105",
            "fax_number": "904-637-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPE AND HEALING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-18",
        "last_updated": "2016-08-29",
        "status": "A",
        "authorized_official_last_name": "BACEVAC",
        "authorized_official_first_name": "SELMA",
        "authorized_official_middle_name": "ZAKOMAC",
        "authorized_official_title_or_position": "OWNER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "800-896-6105",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010484600",
            "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 Aug 29, 2016; 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.