Individual provider Active NPI

Jamicia Harley, ED.D

  • Case Manager/Care Coordinator
  • Jacksonville, FL
National Provider Identifier
1871933887
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
CBHCMS.0100869 Issued in FL
Practice address
3119 Spring Glen Rd Ste 115
Jacksonville, FL 32207-5921
Phone
(904) 660-8835
NPI assigned
Jul 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X FL
Case Manager/Care Coordinator 171M00000X CBHCMS.0100869 FL Primary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MH26400 FL
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

3119 Spring Glen Rd Ste 115
Jacksonville, FL 32207-5921

Mailing address

550 Balmoral Cir N Ste 209
Jacksonville, FL 32218-5577
Phone (904) 660-8835

Other practice location 1

550 Balmoral Cir N Ste 208
Jacksonville, FL 32218-5577
Phone (904) 600-6763

Other identifiers 2

IdentifierTypeStateIssuer
128817800MedicaidFL
015704500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260611004198 FL Practitioner - Mental Health Counselor 4880166750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

550 Balmoral Cir N
Suite 209
Jacksonville, FL 32218-5577

9835 Lake Worth Rd
Lake Worth, FL 33467-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH26400FLMDMental Health Counselor
CBHCMS.0100869FLMDCase Manager/Care Coordinator

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1871933887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 BALMORAL CIR N STE 209",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322185577",
            "telephone_number": "904-660-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3119 SPRING GLEN RD STE 115",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075921",
            "telephone_number": "904-660-8835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Balmoral Cir N Ste 208",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322185577",
            "country_code": "US",
            "telephone_number": "904-600-6763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARLEY",
        "first_name": "JAMICIA",
        "name_prefix": "Dr.",
        "credential": "ED.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-05",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "CBHCMS.0100869",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH26400",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128817800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015704500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.