Hathcock Counseling, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

HATHCOCK COUNSELING, LLC

Practice address

178 Worthington Pkwy
St Johns, FL 32259-6916

Phone

(904) 314-3380

Fax

(904) 314-3380

NPI assigned

Aug 1, 2024

Organization subpart

No

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

Authorized official

Name

Kared M Dixon Hathcock, LMHC

Title

Owner

Phone

(904) 314-3380

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karen Dixon Hathcock, LMHC

  • Mental Health Counselor
  • St Johns, FL
  • NPI 1710251301
  Medicare reassignment NPD

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1801625264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 STATE ROAD NORTH",
            "address_2": "SUITE 11-79",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "32259",
            "telephone_number": "904-314-3380",
            "fax_number": "904-314-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 WORTHINGTON PKWY",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322596916",
            "telephone_number": "904-314-3380",
            "fax_number": "904-314-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HATHCOCK COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "DIXON HATHCOCK",
        "authorized_official_first_name": "KARED",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-314-3380",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Kim Han
• Gabrielle Shaw Hardman, DC
• Robert Trevor Hardman
• Leslie Jennice Harrison, LMFT
• Micaela Harrison, DNP
• Dana M Hatwig, APRN
• Healing Heart Behavioral Consultation
• Healing Roots Chiropractic Centers LLC
• Healx Care LLC
• Cestau Henry

• Mental Health Counselor in St Johns, FL
• Providers in St Johns, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.