Active NPI
Andrieah Johnson, LMHC, CAMS, CCTP
- Mental Health Counselor
- Jacksonville, FL
National Provider Identifier
1760809115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH14518
- Practice address
- 1222 Clock St
Jacksonville, FL 32211-8853 - Phone
- (904) 577-0087
- Fax
- (844) 846-2463
- NPI assigned
- Mar 24, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 14518 | FL | |
| Mental Health Counselor | 101YM0800X | IMH11851 | FL | |
| Mental Health Counselor | 101YM0800X | MH14518 | FL | Primary |
Addresses
Primary practice location
1222 Clock St
Jacksonville, FL 32211-8853
Mailing address
7643 Gate Pkwy Ste 104-1139
Jacksonville, FL 32256-3092
Phone (904) 577-0087
Other practice location 1
4595 Lexington Ave
Jacksonville, FL 32210-2058
Phone (904) 448-4700 ext. 507
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 |
|---|---|---|---|
| 14518 | FL | MD | Mental Health Counselor |
| IMH11851 | FL | MD | Mental Health Counselor |
| MH14518 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connected Conversations Counseling, L.L.C. | Mental Health | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Jacksonville, FL
- NPI 1407383102
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665964800000",
"number": "1760809115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7643 GATE PKWY STE 104-1139",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322563092",
"telephone_number": "904-577-0087",
"fax_number": "844-846-2463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1222 CLOCK ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322118853",
"telephone_number": "904-577-0087",
"fax_number": "844-846-2463"
}
],
"practiceLocations": [
{
"address_1": "4595 Lexington Ave",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322102058",
"country_code": "US",
"telephone_number": "904-448-4700 x507",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "ANDRIEAH",
"credential": "LMHC, CAMS, CCTP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-24",
"last_updated": "2022-10-17",
"certification_date": "2022-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "14518",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMH11851",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH14518",
"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 Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.