Individual provider Active NPI

Jessica Ann Lanier, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1912051764
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH8684 Issued in FL
Practice address
4844 Deer Lake Dr W Ste 101
Jacksonville, FL 32246-4406
Phone
(904) 376-3800
Fax
(904) 390-7431
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH8684 FL Primary

Addresses

Primary practice location

4844 Deer Lake Dr W Ste 101
Jacksonville, FL 32246-4406

Mailing address

224 Oleander St
Neptune Beach, FL 32266-4850
Phone (904) 982-1255

Other practice location 1

2354 University Blvd N
Jacksonville, FL 32211-3228
Phone (904) 982-1255

Other identifiers 1

IdentifierTypeStateIssuer
767680800MedicaidFL

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
MH8684FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Behavioral Health, LLC Mental Health CurrentSince Jan 21, 2022 Accepting new patients

Locations

4844 Deer Lake Dr W
Ste 101
Jacksonville, FL 32246

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1912051764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 OLEANDER ST",
            "city": "NEPTUNE BEACH",
            "state": "FL",
            "postal_code": "322664850",
            "telephone_number": "904-982-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4844 DEER LAKE DR W STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322464406",
            "telephone_number": "904-376-3800",
            "fax_number": "904-390-7431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2354 University Blvd N",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322113228",
            "country_code": "US",
            "telephone_number": "904-982-1255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANIER",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767680800",
            "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 Jan 13, 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.