Active NPI
Laura Lea Peddie-Bravo, LMHC
- Mental Health Counselor
- Winter Park, FL
National Provider Identifier
1043337868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH6561
- Practice address
- 7221 Aloma Ave Ste 300
Winter Park, FL 32792-7137 - Phone
- (407) 222-6239
- NPI assigned
- Mar 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH6561 | FL | Primary |
Addresses
Primary practice location
7221 Aloma Ave Ste 300
Winter Park, FL 32792-7137
Mailing address
7221 Aloma Ave Ste 300
Winter Park, FL 32792-7137
Phone (407) 222-6239
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 4, 2024 through Apr 4, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH6561 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521417600000",
"number": "1043337868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7221 ALOMA AVE STE 300",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327927137",
"telephone_number": "407-222-6239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7221 ALOMA AVE STE 300",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327927137",
"telephone_number": "407-222-6239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDDIE-BRAVO",
"first_name": "LAURA",
"middle_name": "LEA",
"name_prefix": "Mrs.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-25",
"last_updated": "2018-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH6561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.