Individual provider Active NPI

Thalia Iveth Anyosa

  • Addiction (Substance Use Disorder) Counselor
  • Jacksonville, FL
National Provider Identifier
1780346155
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
590 Ellis Rd S BLDG 4
Jacksonville, FL 32254-3555
Phone
(904) 800-2231
NPI assigned
Oct 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X FL
Addiction (Substance Use Disorder) Counselor 101YA0400X FL Primary

Addresses

Primary practice location

590 Ellis Rd S BLDG 4
Jacksonville, FL 32254-3555

Mailing address

3500 University Blvd N Apt 1504
Jacksonville, FL 32277-2354
Phone (786) 440-4403

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

NPI Registry JSON

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1780346155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 UNIVERSITY BLVD N APT 1504",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322772354",
            "telephone_number": "786-440-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 ELLIS RD S BLDG 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322543555",
            "telephone_number": "904-800-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANYOSA",
        "first_name": "THALIA",
        "middle_name": "IVETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": null,
            "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 12, 2021; 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.