Organization Active NPI

Chemical Dependency Counseling, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jacksonville, FL
National Provider Identifier
1700179868
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
MH1184 Issued in FL
Legal business name
CHEMICAL DEPENDENCY COUNSELING, INC.
Practice address
300 W Adams St Ste 240
Jacksonville, FL 32202-4365
Phone
(904) 353-2949
Fax
(904) 353-2959
NPI assigned
May 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2011

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

Authorized official

Name
Mr. John A. Davis III, PMD
Title
Program Manager
Phone
(904) 353-2949

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X MH1184 FL Primary

Addresses

Primary practice location

300 W Adams St Ste 240
Jacksonville, FL 32202-4365

Mailing address

300 W Adams St Ste 240
Jacksonville, FL 32202-4365
Phone (904) 353-2949

National Provider Directory

National Provider Directory

Locations

300 W Adams St
Ste 240
Jacksonville, FL 32202
Phone (904) 353-2949

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306195200000",
    "number": "1700179868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W ADAMS ST STE 240",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024365",
            "telephone_number": "904-353-2949",
            "fax_number": "904-353-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W ADAMS ST STE 240",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024365",
            "telephone_number": "904-353-2949",
            "fax_number": "904-353-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEMICAL DEPENDENCY COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-24",
        "last_updated": "2011-05-24",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "904-353-2949",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PMD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "FL",
            "license": "MH1184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; 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.