Jacqueline Dougherty

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH16753 Issued in FL

Practice address

4475 US Highway 1 S Ste 608
Saint Augustine, FL 32086-7282

Phone

(904) 447-7525

NPI assigned

Mar 31, 2019

Sex

Female

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

Practice roles

Locations

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.

• Brooke Counseling Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Augustine, FL
  • NPI 1063974806
  NPD Authorized official
• Brooke Counseling Services Corp

  • Mental Health Counselor
  • St Augustine, FL
  • NPI 1407656127
  NPD Authorized official

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

{
    "created_epoch": "1553990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553990400000",
    "number": "1992266928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4475 US HIGHWAY 1 S STE 608",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320867282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 US HIGHWAY 1 S STE 608",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320867282",
            "telephone_number": "904-447-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-31",
        "last_updated": "2019-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deyoung Don, PT, DPT
• Bibiana Donahue
• Haley Margaret Donahue
• Daniel J Donofrio, MD
• Holly Beth Doucette, ARNP
• Siobhan M Douglas, LCSW
• Lene Douthett
• Dovez Nest Home LLC
• Dovez Nest Home LLC
• Rebecca H Downey

• Mental Health Counselor in Saint Augustine, FL
• Providers in Saint Augustine, 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 Mar 31, 2019; 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.