Individual provider Active NPI

Jo Cisco, LMHC

  • Case Manager/Care Coordinator
  • Middleburg, FL
National Provider Identifier
1881743862
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
3292 County Road 220
Middleburg, FL 32068-4357
Phone
(904) 291-5561
Fax
(904) 278-5659
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary
Mental Health Counselor 101YM0800X MH5101 FL

Addresses

Primary practice location

3292 County Road 220
Middleburg, FL 32068-4357

Mailing address

1726 Kingsley Ave Ste 2
Orange Park, FL 32073-4411
Phone (904) 278-5644

Other identifiers 1

IdentifierTypeStateIssuer
Z9156OtherFLBLUECROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH5101FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1881743862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 KINGSLEY AVE STE 2",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734411",
            "telephone_number": "904-278-5644",
            "fax_number": "904-278-5659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3292 COUNTY ROAD 220",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320684357",
            "telephone_number": "904-291-5561",
            "fax_number": "904-278-5659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISCO",
        "first_name": "JO",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH5101",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "Z9156",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.