Individual provider Active NPI

Brandi Suzanne Boyette

  • Mental Health Counselor
  • Crestview, FL
National Provider Identifier
1063385482
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH28423 Issued in FL
Practice address
160 Alabama St
Crestview, FL 32536-2544
Phone
(850) 684-4651
NPI assigned
Sep 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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 IMH28423 FL Primary

Addresses

Primary practice location

160 Alabama St
Crestview, FL 32536-2544

Mailing address

5407 Highway 4
Baker, FL 32531-8435
Phone (850) 312-8680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IMH28423FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1758672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1063385482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5407 HIGHWAY 4",
            "city": "BAKER",
            "state": "FL",
            "postal_code": "325318435",
            "telephone_number": "850-312-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ALABAMA ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325362544",
            "telephone_number": "850-684-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYETTE",
        "first_name": "BRANDI",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-24",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH28423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.