Individual provider Active NPI

Kimberly Julia, LCSW

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1679942031
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1138 Edgewood Ave S
Jacksonville, FL 32205-5369
Phone
(904) 383-7757
NPI assigned
Sep 16, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 2

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

Addresses

Primary practice location

1138 Edgewood Ave S
Jacksonville, FL 32205-5369

Mailing address

5303 Fremont St
Jacksonville, FL 32210-4017
Phone (904) 383-7757

Other names 1

  • Kimberly Bentley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 21, 2025 through Nov 21, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1679942031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5303 FREMONT ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322104017",
            "telephone_number": "904-383-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 EDGEWOOD AVE S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322055369",
            "telephone_number": "904-383-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JULIA",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BENTLEY",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.