Active NPI
Chemical Dependency Counseling, Inc.
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Jacksonville, FL
National Provider Identifier
1700179868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- License
- MH1184
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryLocations
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.
-
- Professional Counselor
- Jacksonville, FL
- NPI 1013292663
-
- Professional Counselor
- Jacksonville, FL
- NPI 1851685762
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.