NPIMap

Organization Active NPI

Mandarin Counseling Inc

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1811187271
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW6689 Issued in FL
Legal business name
MANDARIN COUNSELING INC
Practice address
12058 San Jose Blvd
Ste 703
Jacksonville, FL 32223-8666
Phone
(904) 260-0454
Fax
(904) 260-0044
NPI assigned
Jul 31, 2007
Last updated
Sep 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Authorized official

Name
Lynda R Mance, LCSWNPI 1730182940
Title
Owner
Phone
(904) 260-0454

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW6689 FL Primary

Addresses

Primary practice location

12058 San Jose Blvd
Ste 703
Jacksonville, FL 32223-8666

Mailing address

12058 San Jose Blvd
Ste 703
Jacksonville, FL 32223
Phone (904) 260-0454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080916000252 FL Part B Supplier - Clinic/Group Practice 0143397281 Receives reassigned benefits from 5 practitioners
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

12058 San Jose Blvd
Ste 703
Jacksonville, FL 32223
Phone (904) 260-0454

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1811187271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12058 SAN JOSE BLVD",
            "address_2": "STE 703",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-260-0454",
            "fax_number": "904-260-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12058 SAN JOSE BLVD",
            "address_2": "STE 703",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238666",
            "telephone_number": "904-260-0454",
            "fax_number": "904-260-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANDARIN COUNSELING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "MANCE",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-260-0454",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6689",
            "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 Sep 16, 2008; 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.