Kimberly M Mitchell, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

19999 Issued in FL

Practice address

12412 San Jose Blvd Ste 304
Jacksonville, FL 32223-8620

Phone

(904) 649-9771

NPI assigned

Oct 20, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1831852441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12412 SAN JOSE BLVD STE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238620",
            "telephone_number": "904-649-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12412 SAN JOSE BLVD STE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238620",
            "telephone_number": "904-649-9771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12627 San Jose Blvd Ste 504B",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322238641",
            "country_code": "US",
            "telephone_number": "904-649-9771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "19088",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "19999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimberly@bluephoenixcounseling.com",
            "affiliation": "N",
            "endpointDescription": "Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7635 Timberlin Park Blvd Apt 1321",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322566730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kay Mullinax Mitchell, M.D.
• Kelly L Mitchell, LMHC
• Kelsea Mitchell
• Kevin M Mitchell, D.D.S.
• Kia Michon Mitchell, M.D.
• Lacendia Mitchell
• Lisa Mitchell
• Lyndsey Jean Mitchell, APRN
• Mackel Mitchell, APRN
• Miranda Eve Mitchell, RN, MSN, FNP-BC

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, 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 May 9, 2025; 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.