St Johns County Board of County Commissioners

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ST JOHNS COUNTY BOARD OF COUNTY COMMISSIONERS

Practice address

1955 US Highway 1 S
Suite C-2
St Augustine, FL 32086-3708

Phone

(904) 209-6001

Fax

(904) 209-6002

NPI assigned

Oct 19, 2005

Organization subpart

No

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

Authorized official

Name

Maria Colavito, PHD

Title

Health & Human Services Director

Phone

(904) 209-6082

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• ST JOHNS COUNTY MENTAL HEALTH DEPARTMENT Other name

Locations

Practitioners 1

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

• James Berwick, LCSW

  • Clinical Social Worker
  • St Augustine, FL
  • NPI 1265421259
  NPD

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1629067970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 US HIGHWAY 1 S",
            "address_2": "SUITE C-2",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863708",
            "telephone_number": "904-209-6001",
            "fax_number": "904-209-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 US HIGHWAY 1 S",
            "address_2": "SUITE C-2",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863708",
            "telephone_number": "904-209-6001",
            "fax_number": "904-209-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHNS COUNTY BOARD OF COUNTY COMMISSIONERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "COLAVITO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "HEALTH & HUMAN SERVICES DIRECTOR",
        "authorized_official_telephone_number": "904-209-6082",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUTPATIENT SERVICES",
            "identifier": "39301",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST JOHNS COUNTY MENTAL HEALTH DEPARTMENT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• St Johns Cardiovascular PA
• St Johns Co Council on Aging
• St Johns County Board of County Commissioners
• St Johns County Board of County Commissioners
• St Johns County Board of County Commissioners
• St Johns County Welfare Federation
• St Johns County Welfare Federation
• St Johns County Welfare Federation
• St Johns Eye Associates PA
• St Johns Eye Associates PA

• Mental Health Clinic/Center (Including Community Mental Health Center) in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.