J Churchwell Counseling

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

J CHURCHWELL COUNSELING

Practice address

2200 N Ponce de Leon Blvd Ste 3
St Augustine, FL 32084-2650

Phone

(904) 377-4200

Fax

(904) 485-8019

NPI assigned

Mar 12, 2018

Last updated

Nov 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jill Yoerger-Churchwell, LCSWNPI 1629417472

Title

Owner

Phone

(904) 377-4200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jill Yoerger-Churchwell

  • Clinical Social Worker
  • St Augustine, FL
  • NPI 1629417472
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1922501493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 N PONCE DE LEON BLVD STE 3",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842650",
            "telephone_number": "904-377-4200",
            "fax_number": "904-485-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 N PONCE DE LEON BLVD STE 3",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842650",
            "telephone_number": "904-377-4200",
            "fax_number": "904-485-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J CHURCHWELL COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-12",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "YOERGER-CHURCHWELL",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-377-4200",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.