Individual provider Active NPI

Meghan Marie Fencer, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1508050089
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH10539 Issued in FL
Practice address
4040 Woodcock Dr
Midtown Centre Building 2200 Suite 232
Jacksonville, FL 32207-2720
Phone
(904) 651-0237
NPI assigned
Aug 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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 MH10539 FL Primary

Addresses

Primary practice location

4040 Woodcock Dr
Midtown Centre Building 2200 Suite 232
Jacksonville, FL 32207-2720

Mailing address

1015 Atlantic Blvd # 208
Atlantic Beach, FL 32233-3313
Phone (904) 651-0237

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
MH10539FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1508050089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 ATLANTIC BLVD # 208",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322333313",
            "telephone_number": "904-651-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 WOODCOCK DR",
            "address_2": "MIDTOWN CENTRE BUILDING 2200 SUITE 232",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072720",
            "telephone_number": "904-651-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENCER",
        "first_name": "MEGHAN",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10539",
            "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 Jun 15, 2011; 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.