Active NPI
Jenna Nicole Gosden, LMHC
- Mental Health Counselor
- Jacksonville, FL
National Provider Identifier
1871998393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH12605
- Practice address
- 2892 Forbes St
Jacksonville, FL 32205-7572 - Phone
- (717) 919-1725
- Fax
- (904) 384-5753
- NPI assigned
- Oct 27, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH12605 | FL | Primary |
Addresses
Primary practice location
2892 Forbes St
Jacksonville, FL 32205-7572
Mailing address
555 Stockton St
Jacksonville, FL 32204-2534
Phone (904) 387-4461
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH12605 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585008000000",
"number": "1871998393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 STOCKTON ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322042534",
"telephone_number": "904-387-4461",
"fax_number": "904-384-5753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2892 FORBES ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322057572",
"telephone_number": "717-919-1725",
"fax_number": "904-384-5753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSDEN",
"first_name": "JENNA",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-27",
"last_updated": "2020-03-24",
"certification_date": "2020-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH12605",
"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 Mar 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.