Individual provider Active NPI

Brianna Doran

  • Mental Health Counselor
  • Melbourne, FL
National Provider Identifier
1053971531
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
21309 Issued in FL
Practice address
1250 W Eau Gallie Blvd Ste a
Melbourne, FL 32935-5385
Phone
(321) 376-0230
NPI assigned
Jun 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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 21309 FL Primary

Addresses

Primary practice location

1250 W Eau Gallie Blvd Ste a
Melbourne, FL 32935-5385

Mailing address

1250 W Eau Gallie Blvd Ste a
Melbourne, FL 32935-5385
Phone (321) 376-0230

Other practice location 1

256 Norwich St
Merritt Island, FL 32953-8210
Phone (860) 302-8628

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
I20240306003745 FL Practitioner - Mental Health Counselor 2961848460 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21309FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Soul Haven Counseling & Consulting, LLC Current Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Feb 1, 2024 Accepting new patients
Shine Medical Providers PC Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 3

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": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1053971531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W EAU GALLIE BLVD STE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355385",
            "telephone_number": "321-376-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W EAU GALLIE BLVD STE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355385",
            "telephone_number": "321-376-0230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "256 Norwich St",
            "address_purpose": "LOCATION",
            "city": "Merritt Island",
            "state": "FL",
            "postal_code": "329538210",
            "country_code": "US",
            "telephone_number": "860-302-8628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORAN",
        "first_name": "BRIANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2022-11-29",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "21309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.