Active NPI
Jacqueline J. Reycraft, LMHC
- Mental Health Counselor
- Lakeland, FL
National Provider Identifier
1922278456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH7940
- Practice address
- 5110 S Florida Ave Ste 105
Lakeland, FL 33813-2517 - Phone
- (863) 510-5902
- Fax
- (863) 510-5903
- NPI assigned
- Mar 12, 2008
- 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 | MH7940 | FL | Primary |
Addresses
Primary practice location
5110 S Florida Ave Ste 105
Lakeland, FL 33813-2517
Mailing address
5110 S Florida Ave Ste 105
Lakeland, FL 33813-2517
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 |
|---|---|---|---|
| MH7940 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281916800000",
"number": "1922278456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5110 S FLORIDA AVE STE 105",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338132517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5110 S FLORIDA AVE STE 105",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338132517",
"telephone_number": "863-510-5902",
"fax_number": "863-510-5903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYCRAFT",
"first_name": "JACQUELINE",
"middle_name": "J.",
"name_prefix": "Mrs.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-12",
"last_updated": "2010-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH7940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.