Individual provider Active NPI

John Joseph Pimentel Jr., LMHC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1912474909
Registry record updated Oct 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH16276 Issued in FL
Practice address
4615 Philips Hwy
Jacksonville, FL 32207-9506
Phone
(904) 739-7022
NPI assigned
Oct 27, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2018

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 MH16276 FL Primary

Addresses

Primary practice location

4615 Philips Hwy
Jacksonville, FL 32207-9506

Mailing address

2522 College St
Jacksonville, FL 32204-3555
Phone (904) 962-6404

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
I20231130002491 FL Practitioner - Mental Health Counselor 5890143820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2055 Reyko Rd
Suite 100
Jacksonville, FL 32207-2822
Phone (904) 648-8200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH16276FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

2055 Reyko Rd
Ste 100
Jacksonville, FL 32207
Phone (904) 648-8200

1542 Kingsley Ave
Ste 136
Orange Park, FL 32073
Phone (904) 214-3222

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Organizations & group practices 2

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": "1540598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540598400000",
    "number": "1912474909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 COLLEGE ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043555",
            "telephone_number": "904-962-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 PHILIPS HWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079506",
            "telephone_number": "904-739-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIMENTEL",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-27",
        "last_updated": "2018-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.