Active NPI
Annie Grace Hardwick, LMHC
- Mental Health Counselor
- St Augustine, FL
National Provider Identifier
1659072866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH21390
- Practice address
- 3955 Lewis Speedway
St Augustine, FL 32084-8611 - Phone
- (904) 209-2241
- NPI assigned
- Mar 14, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH21390 | FL | Primary |
Addresses
Primary practice location
3955 Lewis Speedway
St Augustine, FL 32084-8611
Mailing address
355 La Mancha Dr
St Augustine, FL 32086-0398
Phone (904) 704-0117
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
| License | State | Type | Specialty |
|---|---|---|---|
| MH21390 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678752000000",
"number": "1659072866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 LA MANCHA DR",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320860398",
"telephone_number": "904-704-0117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3955 LEWIS SPEEDWAY",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320848611",
"telephone_number": "904-209-2241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARDWICK",
"first_name": "ANNIE",
"middle_name": "GRACE",
"name_prefix": "Mrs.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-14",
"last_updated": "2023-03-14",
"certification_date": "2023-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH21390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.