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ANGELICA WITHERSPOON
NPI 1215612718
Counselor - Mental Health in Jacksonville, FL

Active since June 21, 2023PECOS EnrolledAccepts Medicare Assignment
820 PRUDENTIAL DR STE 510, JACKSONVILLE, FL 32207(904) 376-3800 Get Directions Write a Review

NPPES record last updated: October 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Angelica Witherspoon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANGELICA WITHERSPOON (NPI 1215612718) is an individual mental health provider in Jacksonville, Florida, licensed in Florida (MH26767) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1215612718
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameANGELICA WITHERSPOON
Location Address820 PRUDENTIAL DR STE 510Jacksonville, FL 32207-8207
Mailing AddressPo Box 748519Atlanta, GA 30374-8519 · (904) 376-3800 · Fax (904) 376-3998
Phone(904) 376-3800
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateJune 21, 2023
Last NPPES UpdateOctober 30, 2025
NPPES CertifiedOctober 30, 2025
✔ NPI 1215612718 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in FL · MH26767
820 PRUDENTIAL DR STE 510, Jacksonville, FL 32207
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Angelica Witherspoon is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628568755
PECOS Enrollment IDI20251106005160
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELISSA NELSEN APRN
Nurse Practitioner (Psychiatric/Mental Health)
820 PRUDENTIAL DR STE 510
JACKSONVILLE, FL 32207
Duval County (904) 376-3800
JOSEPH VELASQUEZ PSY.D.
Student in an Organized Health Care Education/Training Program
820 PRUDENTIAL DR STE 510
JACKSONVILLE, FL 32207
Duval County (904) 376-3800
RASHARIA C. CASON LCSW
Social Worker (Clinical)
820 PRUDENTIAL DR STE 510
JACKSONVILLE, FL 32207
Duval County (904) 376-3800
CHELSEA TAYLOR MOON-TISON
Social Worker (Clinical)
820 PRUDENTIAL DR STE 510
JACKSONVILLE, FL 32207
Duval County (904) 376-3800
DANIELA WOODWARD
Student in an Organized Health Care Education/Training Program
820 PRUDENTIAL DR STE 510
JACKSONVILLE, FL 32207
Duval County (904) 376-3800
ALICIA S EVANS
Nurse Practitioner (Psychiatric/Mental Health)
820 PRUDENTIAL DR STE 510
JACKSONVILLE, FL 32207
Duval County (904) 376-3800
DONALD POLLOCK MD.
Psychiatry & Neurology (Psychiatry)
820 PRUDENTIAL DR STE 510
JACKSONVILLE, FL 32207
Duval County (904) 376-3800
RYAN MICHAEL MOROZE M.D.
Psychiatry & Neurology (Psychiatry)
820 PRUDENTIAL DR STE 510
JACKSONVILLE, FL 32207
Duval County (904) 376-3800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Angelica Witherspoon's NPI number?

The NPI number for Angelica Witherspoon is 1215612718. It was assigned to this individual provider in the NPPES registry on June 21, 2023.

Where is Angelica Witherspoon located?

Angelica Witherspoon practices at 820 Prudential Dr Ste 510, Jacksonville, FL 32207. The listed phone number is (904) 376-3800.

What is Angelica Witherspoon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Angelica Witherspoon enrolled in Medicare?

Yes. Angelica Witherspoon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Angelica Witherspoon was last updated on October 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.