Individual provider Active NPI

Jennifer Mejia, LCSW

  • Clinical Social Worker
  • St Augustine, FL
National Provider Identifier
1487456216
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW24465 Issued in FL
Practice address
340 Paseo Reyes Dr
Saint Augustine, FL 32095-8464
Phone
(904) 834-5927
NPI assigned
Mar 25, 2025
Last updated
Mar 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW24465 FL Primary

Addresses

Primary practice location

340 Paseo Reyes Dr
Saint Augustine, FL 32095-8464

Mailing address

90 Via Sonrisa
Saint Augustine, FL 32092-3128
Phone (904) 553-9589

Other practice location 1

8130 Baymeadows Cir W
Jacksonville, FL 32256-1880
Phone (904) 618-4757

Other names 1

  • Jennifer Halula Former name

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
SW24465FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1487456216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 VIA SONRISA",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923128",
            "telephone_number": "904-553-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 PASEO REYES DR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320958464",
            "telephone_number": "904-834-5927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8130 Baymeadows Cir W",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322561880",
            "country_code": "US",
            "telephone_number": "904-618-4757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW24465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HALULA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.