Individual provider Active NPI

James V Eaton, LMHC

  • Mental Health Counselor
  • Satellite Beach, FL
National Provider Identifier
1063479871
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 1553 Issued in FL
Practice address
1275 S Patrick Dr
Suite C
Satellite Beach, FL 32937-3963
Phone
(321) 779-0938
Fax
(321) 779-4502
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MH 1553 FL Primary

Addresses

Primary practice location

1275 S Patrick Dr
Suite C
Satellite Beach, FL 32937-3963

Mailing address

1275 S Patrick Dr
Suite C
Satellite Beach, FL 32937-3963
Phone (321) 779-0938

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
I20240131004450 FL Practitioner - Mental Health Counselor 2961855465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adult and Child Counseling and Psychiatric Center, P.aGroup PAC ID 0042403610, 13 clinicians

Practice addresses (Care Compare)

5545 N Wickham Rd
Suite 110
Melbourne, FL 32940-7323
Phone (321) 779-9838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH 1553FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Adult & Child Counseling and Psychiatric Center, P.a. Mental Health CurrentSince Sep 13, 2024 Accepting new patients

Locations

5545 N Wickham Rd
Ste 110
Melbourne, FL 32940
Phone (321) 452-5633

1275 South Patrick Dr
Ste C
Satellite Beach, FL 32937
Phone (321) 779-0213

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063479871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 S PATRICK DR",
            "address_2": "SUITE C",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329373963",
            "telephone_number": "321-779-0938",
            "fax_number": "321-779-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 S PATRICK DR",
            "address_2": "SUITE C",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329373963",
            "telephone_number": "321-779-0938",
            "fax_number": "321-779-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "JAMES",
        "middle_name": "V",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 1553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Satellite Beach, FL

Sources for this page

Verify at the official NPI Registry.