Active NPI
Tracy Redman, LHMC
- Mental Health Counselor
- Jacksonville, FL
National Provider Identifier
1982046876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH16290
- Practice address
- 3781 San Jose PL
Wisecounsel Ste 29
Jacksonville, FL 32257 - Phone
- (904) 472-6179
- Fax
- (833) 974-0773
- NPI assigned
- Jul 22, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH16290 | FL | Primary |
Addresses
Primary practice location
3781 San Jose PL
Wisecounsel Ste 29
Jacksonville, FL 32257
Mailing address
12469 Joda LN E
Jacksonville, FL 32258-2109
Phone (904) 472-6179
Other practice location 1
3810-3 Williamsburg Park Blvd Ste 3
Jacksonville, FL 32257-9220
Phone (904) 419-6102
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 |
|---|---|---|---|
| MH16290 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beyond 90 Inc. | Mental Health | Current | Accepting new patients |
| Breakthroughs Counseling & Recovery | Mental Health | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Mental Health Counselor
- Jacksonville, FL
- NPI 1699576041
-
- Clinical Social Worker
- Jacksonville, FL
- NPI 1033133616
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718841600000",
"number": "1982046876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12469 JODA LN E",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322582109",
"telephone_number": "904-472-6179",
"fax_number": "833-974-0773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3781 SAN JOSE PL",
"address_2": "WISECOUNSEL STE 29",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32257",
"telephone_number": "904-472-6179",
"fax_number": "833-974-0773"
}
],
"practiceLocations": [
{
"address_1": "3810-3 Williamsburg Park Blvd Ste 3",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322579220",
"country_code": "US",
"telephone_number": "904-419-6102",
"fax_number": "904-739-2153",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REDMAN",
"first_name": "TRACY",
"name_prefix": "Ms.",
"credential": "LHMC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-22",
"last_updated": "2024-06-20",
"certification_date": "2024-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH16290",
"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 Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.