Casey Wylie, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

9957 Moorings Dr Ste 302
Jacksonville, FL 32257-2415

Phone

(888) 793-2304

Fax

(888) 793-2304

NPI assigned

Dec 14, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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
  NPD

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1619636974",
    "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": "WYLIE",
        "first_name": "CASEY",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-14",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Wyckoff, MD
• Tara Wyckoff, PA-C
• Renee Garcia Wyden, LCSW
• Shannon Beth Wygonik, PHARMD
• Anna Miriam Agatina Wyke, MA
• Natasha Subhan Wylie, ARNP, DNP
• Todd Wick Wylie, M.D.
• Christopher Edward Wyman
• Jordan Taylor-Hoprich Wyman, DNP
• Wyndham Lakes Jacksonville LLC

• 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 Dec 14, 2021; 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.