Stephanie N Waggoner, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH20071 Issued in FL

Practice address

9957 Moorings Dr Ste 302
Jacksonville, FL 32257-2415

Phone

(888) 793-2304

Fax

(888) 793-2304

NPI assigned

Jan 10, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Stephanie N Smith Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greener Side Counseling, LLCGroup PAC ID 8527599059, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Greener Side Counseling, LLC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1689168304
  Medicare reassignment Care Compare group NPD
• Thriveworks Clinical - Florida Inc

  • Mental Health Counselor
  • Fort Lauderdale, FL
  • NPI 1396360996
  Medicare reassignment NPD
• Helping Hands Inspire Happy Hearts, LLC

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1720440373
  NPD (past)
• Inspire Me Partners, Inc.

  • Clinic/Center
  • Jacksonville, FL
  • NPI 1972159622
  NPD (past)

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1538676630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9957 MOORINGS DR STE 302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572415",
            "telephone_number": "888-793-2304",
            "fax_number": "888-793-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9957 MOORINGS DR STE 302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572415",
            "telephone_number": "888-793-2304",
            "fax_number": "888-793-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "STEPHANIE",
        "middle_name": "N",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-10",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH20071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SMITH",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Roger Dale Wade, RN
• Samantha Jayde Wade, MSW
• Sean Wade, M.D.
• Hani Wadei, MD
• Khurram Wadud, M.D.
• Sujata M Wagh, MD
• Alexis Wagner, OTR/L
• Bryan J Wagner, OT, ATC, LAT
• Christy Wagner, APRN
• Debra Lynn Wagner, CNM, ARNP

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.