Individual provider Active NPI

Carrie Simpson, LMHC

  • Mental Health Counselor
  • Jacksonville Beach, FL
National Provider Identifier
1508123647
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH14513 Issued in FL
Practice address
41 37TH Ave S
Jacksonville Beach, FL 32250-5940
Phone
(904) 993-1602
NPI assigned
Apr 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 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 MH14513 FL Primary

Addresses

Primary practice location

41 37TH Ave S
Jacksonville Beach, FL 32250-5940

Mailing address

41 37TH Ave S
Jacksonville Beach, FL 32250-5940
Phone (904) 993-1602

Other identifiers 1

IdentifierTypeStateIssuer
1508132647MedicaidFL

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
MH14513FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1508123647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 37TH AVE S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505940",
            "telephone_number": "904-993-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 37TH AVE S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505940",
            "telephone_number": "904-993-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "CARRIE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-13",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH14513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508132647",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.