OrganizationActive
Black Canary Therapy LLC
NPI 1083597918 · Mental Health Clinic/Center (Including Community Mental Health Center) · St Johns, FL
Provider details
- NPI number
- 1083597918
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Megan London, Owner(850) 524-1616
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
621 Melrose Abbey Ln
St Johns, FL 32259-5906
Phone: (850) 524-1616
Street-level locationGet directions
Mailing address
621 Melrose Abbey Ln
St Johns, FL 32259-5906
Other names (DBA / former)
- Doing business as
- Lifeologie Counseling St Johns
Registry dates
- Enumerated
- 2025-07-29
- Last updated
- 2025-07-29
- Certified
- 2025-07-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.