Kathleen Gundlach

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH19951 Issued in FL

Practice address

7077 Bonneval Rd Ste 603
Jacksonville, FL 32216-6010

Phone

(561) 386-1490

NPI assigned

Jun 20, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: katie.gundlach.p1@direct.sokya.nextgenshare.com

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1861912024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 THE 12TH FAIRWAY",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334145931",
            "telephone_number": "561-386-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7077 BONNEVAL RD STE 603",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166010",
            "telephone_number": "561-386-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDLACH",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH19951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bharat Kumar Gummadi, MD
• Charlene Leona Gunasekera, MD
• Abhijit Gundale
• Amrita Gavrielle Gundavda, PA-S
• Julio Gundian, MD
• Christina Gunn
• Hope Jessecca Gunn, APRN
• Sayer K Gunn, MD
• Shawnikka Gunn, RN
• Kiersten Gunning

• 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 Apr 28, 2022; 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.