NPIMap

Organization Active NPI

Casey Center for Community Counseling

  • Mental Health Counselor
  • Fleming Island, FL
National Provider Identifier
1811513534
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CASEY CENTER FOR COMMUNITY COUNSELING
Doing business as
Casey Center for Community Counseling
Practice address
2386 Stockton Dr
Fleming Island, FL 32003-8787
Phone
(904) 614-4190
NPI assigned
Jun 18, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Authorized official

Name
Mr. David Robert Jedrziewski, MSNPI 1538733779
Title
Coo
Phone
(904) 614-4190

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
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

2386 Stockton Dr
Fleming Island, FL 32003-8787

Mailing address

2386 Stockton Dr
Fleming Island, FL 32003-8787
Phone (904) 614-4190

Other names 1

  • Casey Center for Community Counseling Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL caseycenter.org Direct

National Provider Directory

National Provider Directory
Tax ID family
Casey Center for Community Counseling2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596758400000",
    "number": "1811513534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2386 STOCKTON DR",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038787",
            "telephone_number": "904-614-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2386 STOCKTON DR",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038787",
            "telephone_number": "904-614-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASEY CENTER FOR COMMUNITY COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-18",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A",
        "authorized_official_last_name": "JEDRZIEWSKI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "904-614-4190",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "caseycenter.org",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2386 Stockton Dr",
            "city": "Fleming Island",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320038787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Casey Center for Community Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fleming Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.