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Active NPI 1194512293 Individual Practitioner Female Practitioner

Jacqueline Leigh (Preferred) Mathis , REGISTERED INTERN

Counselor - Mental Health • St Augustine, FL

Professional Overview & Biography Verified Profile Summary

Jacqueline Mathis, REGISTERED INTERN is a registered healthcare professional specializing in Counselor - Mental Health in St Augustine, FL. Practice services are available at 319 W TOWN PL STE 21 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

319 W Town Pl Ste 21

St Augustine, FL 320923103

Telephone 9046409099
Associated Practice Facility / Clinic
🏢 Steven R. Freeman Dds Pl Facility NPI 1982868634

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Mental Health in St Augustine, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.7 Yrs
State Avg: 15.5 Yrs
Regional Practice Density
127 Specialists

Practicing in St Augustine, FL (23930 Statewide)

Telehealth Adoption Rate
0.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-07-01
Counselor - Mental Health Primary Specialty

NUCC Taxonomy Code: 101YM0800X

State License FL MH27996

Definition to come...

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location July 01, 2026

Registered at 319 W TOWN PL STE 21, ST AUGUSTINE, FL 320923103 (Tel: 9046409099)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 01, 2026

Counselor (License #MH27996 in FL)

NPI Profile Active April 22, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location April 22, 2025

Registered at 100 E TOWN PL UNIT 207, ST AUGUSTINE, FL 320920664 (Tel: 8506298242)

📍
Updated Business Mailing Address April 22, 2025

Registered at 2872 N 1ST ST, ST AUGUSTINE, FL 320841942 (Tel: 5616762529)

👤
Provider Name / Credentials Updated April 22, 2025

Recorded as JACQUELINE MATHIS, REGISTERED INTERN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 22, 2025

Counselor (License #IMH25564 in FL)

🟢
Initial NPI Registration & Enumeration April 22, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1194512293
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 22, 2025
Last Update: July 01, 2026
Sole Proprietor: No

Mailing Address

2872 N 1st St

St Augustine, FL 320841942

Phone: 5616762529

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.