MEDICARE: REFLECTIVE MINDS THERAPY, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1770456121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REFLECTIVE MINDS THERAPY, LLC

Provider Business Mailing Address
First Line	:	1015 ATLANTIC BLVD # 103
Second Line	:
City	:	ATLANTIC BEACH
State	:	FL
Zip	:	32233-3313
Country	:	US
Telephone Number	:	904-888-7870
Fax Number	:

Provider Business Practice Location Address
First Line	:	2602 ISABELLA BLVD STE 10
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-8000
Country	:	US
Telephone Number	:	904-888-7870
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ASHLEY MARIE JACOBY
Credential	:	LMHC
Telephone Number	:	904-888-7870

Provider Enumeration Date	:	09/23/2025
Last Update Date	:	04/14/2026

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Directions to “REFLECTIVE MINDS THERAPY, LLC ” Practice Location

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