MEDICARE: CREATIVE MINDS & CONNECTIONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	101Y00000X	Counselor
4	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1740173624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATIVE MINDS & CONNECTIONS

Provider Business Mailing Address
First Line	:	10163 FORTUNE PKWY
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-3519
Country	:	US
Telephone Number	:	904-749-3869
Fax Number	:	904-644-3299

Provider Business Practice Location Address
First Line	:	10163 FORTUNE PKWY
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-3519
Country	:	US
Telephone Number	:	904-749-3869
Fax Number	:	904-944-3036

Authorized Official
Title or Position	:	OWNER
Name	:	MS. MICHELLE SOARES PEREIRA
Credential	:	LMHC
Telephone Number	:	904-749-3869

Provider Enumeration Date	:	05/30/2025
Last Update Date	:	03/23/2026

Similar Medicare Providers

1033058912 — LEGACY VITALITY & WELLNESS LLC
Practice Location Address:

10163 FORTUNE PKWY
JACKSONVILLE, FL
32256-3519

Practice Phone: 850-319-1491
Practice Fax:

1538729892 — LITZY LOPEZ HERNANDEZ
Practice Location Address:

10163 FORTUNE PKWY STE G25-G27
JACKSONVILLE, FL
32256-3519

Practice Phone: 904-662-7093
Practice Fax:

1518670652 — MINDME LLC
Practice Location Address:

10163 FORTUNE PKWY
JACKSONVILLE, FL
32256-3519

Practice Phone: 904-299-5387
Practice Fax: 833-624-1727

1477249803 — TELE-MARLYS ADJEVI-NEGLOKPE
Practice Location Address:

10163 FORTUNE PKWY STE G20
JACKSONVILLE, FL
32256-3519

Practice Phone: 904-257-3672
Practice Fax:

1245054303 — ABA BRIGHTWINGS LLC
Practice Location Address:

10163 FORTUNE PKWY # G35
JACKSONVILLE, FL
32256-3519

Practice Phone: 305-303-3236
Practice Fax:

1649088097 — WITHOUT LIMITS THERAPY SERVICES INC
Practice Location Address:

10163 FORTUNE PKWY # G35
JACKSONVILLE, FL
32256-3519

Practice Phone: 305-603-8747
Practice Fax: 305-603-8747

Directions to “CREATIVE MINDS & CONNECTIONS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.