Charles Dean III, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

11471 Issued in FL

Practice address

12400 Yellow Bluff Rd Ste 107
Jacksonville, FL 32226-5070

Phone

(904) 254-8421

NPI assigned

Oct 30, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1635552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1942964457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12400 YELLOW BLUFF RD STE 107",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322265070",
            "telephone_number": "904-254-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 YELLOW BLUFF RD STE 107",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322265070",
            "telephone_number": "904-254-8421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "CHARLES",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-30",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "11471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nyla Deadwiler
• Latisha R Deal
• Angela Deallie
• Amber Nicole Dean, PA
• Anthony T Dean, DDS
• Cynthia Dean, BA
• Jacqueline C Dean, RN
• Julius Dean, MD
• Leesa Ann Dean, RN
• Tiara Dean, M.D.

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.