First Coast Family Counseling, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5472 Issued in FL

Legal business name

FIRST COAST FAMILY COUNSELING, INC.

Practice address

1718 Kingsley Ave Ste 21
Orange Park, FL 32073

Phone

(904) 567-6100

Fax

(904) 602-8055

NPI assigned

Dec 26, 2006

Organization subpart

No

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

Authorized official

Name

Michael G. McClendon, LMHC-MANPI 1972669992

Title

President

Phone

(904) 567-6100

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael G. McClendon, LMHC

  • Mental Health Counselor
  • Orange Park, FL
  • NPI 1972669992
  NPD (past) Authorized official

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541721600000",
    "number": "1619032166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9445",
            "city": "FLEMMING ISLAND",
            "state": "FL",
            "postal_code": "32006",
            "telephone_number": "904-567-6100",
            "fax_number": "904-602-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 KINGSLEY AVE STE 21",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32073",
            "telephone_number": "904-567-6100",
            "fax_number": "904-602-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST FAMILY COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2018-11-09",
        "status": "A",
        "authorized_official_last_name": "MCCLENDON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-567-6100",
        "authorized_official_credential": "LMHC-MA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "5472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767279900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Andrea Filosa, FNP, CNM
• Fiore Chiropractic Office
• Timothy J Fiore, DC
• First Choice Family Practice PA
• First Coast Center for Counseling Inc
• First Coast Medical Network LLC
• First Coast Medical, Inc
• First Coast Mental Health P a
• First Coast Obstetrics Associates, P.a.
• First Coast Optical LLC

• Mental Health Counselor in Orange Park, FL
• Providers in Orange Park, 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 Nov 9, 2018; 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.