Individual provider Active NPI

Erin L Moran, M.S.

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1497209266
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH13965 Issued in FL
Practice address
12443 San Jose Blvd
Suite 202
Jacksonville, FL 32223-8646
Phone
(904) 438-4399
NPI assigned
Aug 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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 IMH13965 FL Primary

Addresses

Primary practice location

12443 San Jose Blvd
Suite 202
Jacksonville, FL 32223-8646

Mailing address

12443 San Jose Blvd
Suite 202
Jacksonville, FL 32223-8646
Phone (904) 438-4399

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
IMH13965FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Journey With Compassion Counseling Mental Health Current Accepting new patients
Sophros Recovery LLC Past Accepting new patients

Locations

12443 San Jose Blvd
Ste 202
Jacksonville, FL 32223
Phone (904) 383-7613

Organizations & group practices 2

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": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1497209266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12443 SAN JOSE BLVD",
            "address_2": "SUITE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238646",
            "telephone_number": "904-438-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12443 SAN JOSE BLVD",
            "address_2": "SUITE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238646",
            "telephone_number": "904-438-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "ERIN",
        "middle_name": "L",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH13965",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 10, 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.