Orchid Soul Wellness and Counseling Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ORCHID SOUL WELLNESS AND COUNSELING SERVICES, LLC

Practice address

3733 University Blvd W Ste 212G
Jacksonville, FL 32217-2155

Phone

(904) 343-5008

NPI assigned

May 8, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Aisha Gordon, LCSWNPI 1346799970

Title

Owner/Therapist

Phone

(336) 407-8213

Specialties & licenses 1

Addresses

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.

• Aisha Gordon, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1346799970
  NPD Authorized official

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1750071478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3733 UNIVERSITY BLVD W STE 212G",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172155",
            "telephone_number": "904-343-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3733 UNIVERSITY BLVD W STE 212G",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172155",
            "telephone_number": "904-343-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORCHID SOUL WELLNESS AND COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "AISHA",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "336-407-8213",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orange Park Medical Center, Inc. (HCA Florida Park West Emergency, a department of HCA Florida Orange Park Hospital)
• Christopher Brian Orange, PA-C
• Jeannine L Orange
• Angela M Oravec, COTA/L
• Tabitha Ann Oravetz, DNP
• Brian Christopher Orcullo, APRN
• Donne Ordile, MPT
• Joshua E Ordu, DO
• Christy Orellana
• Jay Spencer Orellana, CRNA

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.