Authentic Self Counseling of Jacksonville, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

AUTHENTIC SELF COUNSELING OF JACKSONVILLE, LLC

Practice address

9770 Baymeadows Rd Ste 133
Jacksonville, FL 32256-7986

Phone

(904) 990-7117

NPI assigned

Jun 19, 2025

Last updated

Jun 19, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michelle AndersonNPI 1184192866

Title

Owner

Phone

(904) 990-7117

Specialties & licenses 1

Addresses

Tax ID family

Authentic Self Counseling of Jacksonville LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Authentic Self Counseling of Jacksonville, LLC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1407400591
  NPD tax ID
• Authentic Self Counseling of Jacksonville, LLC

  • Mental Health Counselor
  • Fernandina Beach, FL
  • NPI 1982369625
  NPD tax ID

Locations

Practitioners 1

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.

• Michelle Anderson, MS, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1184192866
  Authorized official Same address or phone

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

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1679460018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9770 BAYMEADOWS RD STE 133",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567986",
            "telephone_number": "904-990-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9770 BAYMEADOWS RD STE 133",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567986",
            "telephone_number": "904-990-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTHENTIC SELF COUNSELING OF JACKSONVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-990-7117"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Jun 19, 2025; 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.