Organization Active NPI

Mental Awakening Counseling, LLC

  • Clinical Social Worker
  • Panama City Beach, FL
National Provider Identifier
1659084630
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MENTAL AWAKENING COUNSELING, LLC
Practice address
5 Miracle Strip Loop Ste 8
Panama City Beach, FL 32407-8410
Phone
(850) 235-8495
Fax
(850) 235-8495
NPI assigned
Jan 4, 2023
Last updated
Apr 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Authorized official

Name
Robin Lynn Jordan, LCSWNPI 1568836997
Title
Owner and Provider
Phone
(502) 689-1613

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X NU Primary
Contractor 171W00000X NU

Addresses

Primary practice location

5 Miracle Strip Loop Ste 8
Panama City Beach, FL 32407-8410

Mailing address

5 Miracle Strip Loop Ste 8
Panama City Beach, FL 32407-8410
Phone (850) 235-8495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230216000116 KY Part B Supplier - Clinic/Group Practice 4385016534 Receives reassigned benefits from 1 practitioner
Practice locations: Louisville, KY
O20250527001637 FL Part B Supplier - Clinic/Group Practice 4385016534 Receives reassigned benefits from 4 practitioners
Practice locations: Panama City Beach, FL

National Provider Directory

National Provider Directory

Locations

5 Miracle Strip Loop
Ste 15
Panama City Beach, FL 32407
Phone (850) 235-8495

5 Miracle Strip Loop
Ste 8
Panama City Beach, FL 32407
Phone (850) 235-8495

2950 Breckenridge Ln
Ste 10A
Louisville, KY 40220
Phone (502) 451-6887

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775520000000",
    "number": "1659084630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MIRACLE STRIP LOOP STE 8",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324078410",
            "telephone_number": "850-235-8495",
            "fax_number": "850-235-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MIRACLE STRIP LOOP STE 8",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324078410",
            "telephone_number": "850-235-8495",
            "fax_number": "850-235-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL AWAKENING COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-04",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER AND PROVIDER",
        "authorized_official_telephone_number": "502-689-1613",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.