Letitia Nicolas

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH18504 Issued in FL

Practice address

8540 Baycenter Rd
Jacksonville, FL 32256-7420

Phone

(904) 448-1933

NPI assigned

Jun 24, 2020

Last updated

Jun 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Jewish Family and Community Services

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1861264418
  NPD
• The LJD Jewish Family & Community Services, Inc

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1538255088

  Mental Health

  NPD

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1487270633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 BAYCENTER RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 BAYCENTER RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567420",
            "telephone_number": "904-448-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLAS",
        "first_name": "LETITIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH18504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL PROFESSIONAL  LICENSE",
            "identifier": "IMH18504",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jfcsjax.org",
            "affiliation": "N",
            "address_1": "8540 Baycenter Rd",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322567420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Courtney N Nicholson, PA-C
• Samantha Nicholson
• Steven Michael Nickels, DC DACBN
• Cromartie Nickerson, PHARMD
• Courtney Nicodemus
• Janina Soleil Baraquero Nicolay, OTD, OTR/L
• Nicole M Sweet-McIntire LLC
• Ernst Nicolitz, M.D
• Francesca Nicoloso, PA
• Nidal S Elias DDS PA

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.