AUTHENTIC SELF COUNSELING OF JACKSONVILLE, LLC
NPI 1407400591
Counselor - Mental Health in Jacksonville, FL
About Authentic Self Counseling Of Jacksonville, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AUTHENTIC SELF COUNSELING OF JACKSONVILLE, LLC (NPI 1407400591) is a healthcare organization registered as a mental health in Jacksonville, Florida and active in the NPI registry since July 2019. The organization lists Michelle Anderson, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Authentic Self Counseling Of Jacksonville, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Authentic Self Counseling Of Jacksonville, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Authentic Self Counseling Of Jacksonville, LLC's NPI number?
The NPI number for Authentic Self Counseling Of Jacksonville, LLC is 1407400591. It was assigned to this organization in the NPPES registry on July 28, 2019.
Where is Authentic Self Counseling Of Jacksonville, LLC located?
Authentic Self Counseling Of Jacksonville, LLC is located at 7235 Bentley Rd Ste 308, Jacksonville, FL 32256. The listed phone number is (904) 990-7117.
What is Authentic Self Counseling Of Jacksonville, LLC's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Authentic Self Counseling Of Jacksonville, LLC enrolled in Medicare?
Yes. Authentic Self Counseling Of Jacksonville, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Authentic Self Counseling Of Jacksonville, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Authentic Self Counseling Of Jacksonville, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Authentic Self Counseling Of Jacksonville, LLC accept?
Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Authentic Self Counseling Of Jacksonville, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Authentic Self Counseling Of Jacksonville, LLC was last updated on August 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Authentic Self Counseling Of Jacksonville, Llc · NPI 1407400591
Mental Health organization in Jacksonville, Florida. Organization record, active in the CMS NPPES registry since July 28, 2019.
## Identity
- **NPI:** 1407400591 (Entity type: Organization)
- **Enumerated:** July 28, 2019
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Organization subpart:** No
- **Authorized official:** Michelle Anderson, OWNER
## Practice location
- **Address:** 7235 BENTLEY RD STE 308, Jacksonville, FL 32256-7506
- **Phone:** (904) 990-7117
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Clinical Social Worker) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 8, 2025
- **Other identifiers:** Medicaid 1117302000 (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1407400591) · Data from the CMS NPPES public registry.