Individual provider Active NPI

Alison Brooks Mondares, LCSW

  • Professional Counselor
  • Jacksonville, FL
National Provider Identifier
1619699675
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
SW19167 Issued in FL
Practice address
6149 Bartram Rd S
Jacksonville, FL 32216-2508
Phone
(904) 874-9397
NPI assigned
Sep 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X SW19167 FL Primary

Addresses

Primary practice location

6149 Bartram Rd S
Jacksonville, FL 32216-2508

Mailing address

6149 Bartram Rd S
Jacksonville, FL 32216-2508
Phone (904) 874-9397

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
SW19167FLMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1619699675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6149 BARTRAM RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162508",
            "telephone_number": "904-874-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6149 BARTRAM RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162508",
            "telephone_number": "904-874-9397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDARES",
        "first_name": "ALISON",
        "middle_name": "BROOKS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "SW19167",
            "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 Sep 16, 2022; 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.