Active NPI
Daniel Pridham
- Counselor
- Jacksonville, FL
National Provider Identifier
1972436129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- IMH28776
- Practice address
- 4427 Emerson St Ste 4
Jacksonville, FL 32207-4960 - Phone
- (904) 398-7015
- Fax
- (904) 346-0837
- NPI assigned
- Jun 6, 2026
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | IMH28776 | FL | Primary |
Addresses
Primary practice location
4427 Emerson St Ste 4
Jacksonville, FL 32207-4960
Mailing address
379 Tidewater Dr
Jacksonville, FL 32211-7226
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 |
|---|---|---|---|
| IMH28776 | FL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1780704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1972436129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "379 TIDEWATER DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322117226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4427 EMERSON ST STE 4",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322074960",
"telephone_number": "904-398-7015",
"fax_number": "904-346-0837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIDHAM",
"first_name": "DANIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-06-06",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "IMH28776",
"primary": true
}
],
"identifiers": [],
"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 Aug 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.