Tabatha Melcolm, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH16497 Issued in FL

Practice address

4110 Osceola TRL
Middleburg, FL 32068-7149

Phone

(904) 502-9883

Fax

(904) 490-9037

NPI assigned

Oct 3, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Melcolm Mental Health Services, PLLC

  • Mental Health Counselor
  • Middleburg, FL
  • NPI 1396509865
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1063922276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 OSCEOLA TRL",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320687149",
            "telephone_number": "904-502-9883",
            "fax_number": "904-490-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 OSCEOLA TRL",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320687149",
            "telephone_number": "904-502-9883",
            "fax_number": "904-490-9037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2497 County Road 220",
            "address_purpose": "LOCATION",
            "city": "Middleburg",
            "state": "FL",
            "postal_code": "320686531",
            "country_code": "US",
            "telephone_number": "904-502-9883",
            "fax_number": "904-490-9037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELCOLM",
        "first_name": "TABATHA",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "melcolmmhs@hushmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4110 Osceola Trl",
            "city": "Middleburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320687149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Feliesha Dahnine McCune-Moyer
• Leslie A McDonald, PA-C
• Sascha Rae McGill
• Mediquick,L.L.C.
• Melcolm Mental Health Services, PLLC
• Amos L Melvin Sr., HIS
• Jonathan Michael Melzer, M.D.
• Daniel J Messcher, M.D.
• Mena Ayman Messiha, DPM
• Michelle Meyer

• Mental Health Counselor in Middleburg, FL
• Providers in Middleburg, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.