Individual provider Active NPI

Emely Fernandez

  • Mental Health Counselor
  • Cape Coral, FL
National Provider Identifier
1003358987
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2007 SE 12TH Ter
Cape Coral, FL 33990-1895
Phone
(508) 360-0524
NPI assigned
Nov 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2007 SE 12TH Ter
Cape Coral, FL 33990-1895

Mailing address

2007 SE 12TH Terrace
Cape Coral, FL 33990
Phone (508) 360-0524

Other practice location 1

303 NE 3rd Ave Ste 7&8
Cape Coral, FL 33909-2538
Phone (239) 354-7187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240612000178 FL Practitioner - Mental Health Counselor 9931641479 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12670 New Brittany Blvd
Suite 101
Fort Myers, FL 33907-3650
Phone (239) 837-8555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Traveling Therapist LLC Mental Health CurrentSince May 4, 2024 Accepting new patients
Calm Waters Counseling Group Mental Health CurrentSince Aug 4, 2024 Accepting new patients

Locations

27499 Riverview Center Blvd
Ste 260
Bonita Springs, FL 34134
Phone (239) 344-8420

303 NE 3rd Ave
Ste 78
Cape Coral, FL 33909
Phone (239) 354-7187

12670 New Brittany Blvd
Ste 101
Fort Myers, FL 33907
Phone (239) 354-7227

12670 New Brittany Blvd
Ste 201
Fort Myers, FL 33907
Phone (239) 310-5396

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1003358987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 SE 12TH TERRACE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "33990",
            "telephone_number": "508-360-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 SE 12TH TER",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339901895",
            "telephone_number": "508-360-0524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 NE 3rd Ave Ste 7&8",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339092538",
            "country_code": "US",
            "telephone_number": "239-354-7187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "EMELY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-09",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.