Mental Health America of Northeast Florida, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MENTAL HEALTH AMERICA OF NORTHEAST FLORIDA, INC.

Practice address

4615 Philips Hwy Ste 300
Jacksonville, FL 32207-9506

Phone

(904) 738-8420

Fax

(904) 862-2109

NPI assigned

Feb 3, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Wendy Leigh Hughes, CPA, CRPS

Title

Chief Executive Officer

Phone

(904) 342-9200

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1629468376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 PHILIPS HWY STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079506",
            "telephone_number": "904-738-8420",
            "fax_number": "904-862-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 PHILIPS HWY STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079506",
            "telephone_number": "904-738-8420",
            "fax_number": "904-862-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH AMERICA OF NORTHEAST FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-03",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "904-342-9200",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPA, CRPS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.