Active NPI
Mario E. Decunto
- Mental Health Counselor
- Jacksonville, FL
National Provider Identifier
1730512773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- IMH9607
- Practice address
- 5776 Saint Augustine Rd
Jacksonville, FL 32207-8030 - Phone
- (904) 448-4700
- NPI assigned
- Aug 13, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMH9607 | FL | Primary |
Addresses
Primary practice location
5776 Saint Augustine Rd
Jacksonville, FL 32207-8030
Mailing address
5776 Saint Augustine Rd
Jacksonville, FL 32207-8030
Phone (904) 448-4700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMH9607 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376352000000",
"number": "1730512773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5776 SAINT AUGUSTINE RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078030",
"telephone_number": "904-448-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5776 SAINT AUGUSTINE RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078030",
"telephone_number": "904-448-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECUNTO",
"first_name": "MARIO",
"middle_name": "E.",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-13",
"last_updated": "2013-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMH9607",
"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 Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.