Individual provider Active NPI

Melissa Beth Vandett, LCSW

  • Mental Health Counselor
  • Melbourne, FL
National Provider Identifier
1043888142
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW18340 Issued in FL
Practice address
1301 W Eau Gallie Blvd Ste 96
Melbourne, FL 32935-5390
Phone
(321) 421-6992
NPI assigned
Jun 15, 2021
Last updated
Jun 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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 SW18340 FL Primary

Addresses

Primary practice location

1301 W Eau Gallie Blvd Ste 96
Melbourne, FL 32935-5390

Mailing address

4595 Radiant Way Unit 103
Melbourne, FL 32901-7889
Phone (321) 749-3715

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
I20210908004182 FL Practitioner - Clinical Social Worker 4587060082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Counseling Services, LLCGroup PAC ID 0446415970, 5 clinicians

Practice addresses (Care Compare)

1301 W Eau Gallie Blvd
Suite 96
Melbourne, FL 32935-5390
Phone (321) 421-6992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW18340FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Counseling Services, LLC CurrentSince Aug 19, 2021 Accepting new patients

Locations

1301 W Eau Gallie Blvd
Ste 96
Melbourne, FL 32935
Phone (321) 272-8336

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1043888142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4595 RADIANT WAY UNIT 103",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329017889",
            "telephone_number": "321-749-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W EAU GALLIE BLVD STE 96",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355390",
            "telephone_number": "321-421-6992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDETT",
        "first_name": "MELISSA",
        "middle_name": "BETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW18340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.