Organization Active NPI

Mindme LLC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1518670652
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MINDME LLC
Practice address
10163 Fortune Pkwy
Jacksonville, FL 32256-3519
Phone
(904) 299-5387
Fax
(833) 624-1727
NPI assigned
Jan 4, 2023
Last updated
Dec 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Angela WhittinghillNPI 1376054809
Title
Owner
Phone
(904) 571-4102

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

10163 Fortune Pkwy
Jacksonville, FL 32256-3519

Mailing address

1523 Oak Lace CT
Jacksonville, FL 32225-2847
Phone (904) 571-4102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250106003595 FL Part B Supplier - Clinic/Group Practice 7315475258 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1518670652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 OAK LACE CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322252847",
            "telephone_number": "904-571-4102",
            "fax_number": "833-624-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10163 FORTUNE PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563519",
            "telephone_number": "904-299-5387",
            "fax_number": "833-624-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-04",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "WHITTINGHILL",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-571-4102"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "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 Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.