Individual provider Active NPI

Allison Nicole Fendley, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1770355430
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH26075 Issued in FL
Practice address
836 Prudential Dr Ste 1507
Jacksonville, FL 32207-8342
Phone
(904) 376-3800
Fax
(904) 390-7398
NPI assigned
Oct 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH26075 FL Primary

Addresses

Primary practice location

836 Prudential Dr Ste 1507
Jacksonville, FL 32207-8342

Mailing address

PO Box 748519
Atlanta, GA 30374-8519
Phone (904) 376-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260106000335 FL Practitioner - Mental Health Counselor 7810483229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Behavioral Health LLCGroup PAC ID 7315166394, 120 clinicians

Practice addresses (Care Compare)

836 Prudential Dr
Suite 1507
Jacksonville, FL 32207-8334
Phone (904) 376-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH26075FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
River'S Edge Counseling, PLLC Mental Health CurrentSince Oct 29, 2023 Accepting new patients
River'S Edge Counseling, PLLC Mental Health CurrentSince Oct 29, 2023 Accepting new patients
Baptist Behavioral Health, LLC Mental Health CurrentSince Feb 1, 2026 Accepting new patients

Locations

836 Prudential Dr
Ste 1507
Jacksonville, FL 32207

820 Prudential Dr
Ste 510
Jacksonville, FL 32207

43 Knight Boxx Rd
Ste 1
Orange Park, FL 32065
Phone (904) 379-8675

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1770355430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748519",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748519",
            "telephone_number": "904-376-3800",
            "fax_number": "904-376-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 1507",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078342",
            "telephone_number": "904-376-3800",
            "fax_number": "904-390-7398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENDLEY",
        "first_name": "ALLISON",
        "middle_name": "NICOLE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-26",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH26075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.