Active NPI
Liza White
- Mental Health Counselor
- Jacksonville, FL
National Provider Identifier
1982946737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH20874
- Practice address
- 3138 Brachenbury Lane
Jacksonville, FL 32225-1037 - Phone
- (502) 599-4747
- Fax
- (502) 589-8771
- NPI assigned
- Mar 20, 2013
- 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 | MH20874 | FL | Primary |
Addresses
Primary practice location
3138 Brachenbury Lane
Jacksonville, FL 32225-1037
Mailing address
5027 Peach Mountain Cir
Gainesville, GA 30507-1423
Phone (502) 599-4747
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 |
|---|---|---|---|
| MH20874 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1982946737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5027 PEACH MOUNTAIN CIR",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305071423",
"telephone_number": "502-599-4747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3138 BRACHENBURY LANE",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322251037",
"telephone_number": "502-599-4747",
"fax_number": "502-589-8771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "LIZA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-20",
"last_updated": "2023-06-26",
"certification_date": "2023-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH20874",
"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 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.