Nicole Clinkscale

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1200 Riverplace Blvd Ste 105
Jacksonville, FL 32207-9092

Phone

(904) 720-5689

Fax

(904) 895-6212

NPI assigned

Jul 22, 2019

Last updated

Oct 4, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932
  Medicare reassignment NPD

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759536000000",
    "number": "1629621495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 RIVERPLACE BLVD STE 105",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079092",
            "telephone_number": "904-720-5689",
            "fax_number": "904-895-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 RIVERPLACE BLVD STE 105",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079092",
            "telephone_number": "904-720-5689",
            "fax_number": "904-895-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINKSCALE",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2025-10-04",
        "certification_date": "2025-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clinic for Kidney Diseases PA
• Clinic for Pulmonary and Infectious Diseases PA
• Clinical & Health Psychology
• Clinical & Health Psychology
• Clinical Excellence Integration
• Taryn Clinton
• Evan Clise
• Close the Gap Therapy Solutions, LLC
• Barbara Gail Close, RN
• Morgan Closky, APRN

• 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 Oct 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.