Active NPI
Virginia Lee Hagen, LMHC
- Mental Health Counselor
- Jacksonville, FL
National Provider Identifier
1881818722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH00004267
- Practice address
- 4160 University Blvd S
Jacksonville, FL 32216-4317 - Phone
- (904) 376-3800
- Fax
- (904) 376-3630
- NPI assigned
- Apr 12, 2007
- 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 | MH00004267 | FL | Primary |
Addresses
Primary practice location
4160 University Blvd S
Jacksonville, FL 32216-4317
Mailing address
4160 University Blvd S
Jacksonville, FL 32216-4317
Phone (904) 376-3800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MH0004267 | Other | FL | LICENSE # |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MH00004267 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254355200000",
"number": "1881818722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4160 UNIVERSITY BLVD S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322164317",
"telephone_number": "904-376-3800",
"fax_number": "904-376-3630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4160 UNIVERSITY BLVD S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322164317",
"telephone_number": "904-376-3800",
"fax_number": "904-376-3630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGEN",
"first_name": "VIRGINIA",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2009-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH00004267",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "MH0004267",
"state": "FL"
}
],
"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 Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.