Individual provider Active NPI

Audrey Doris Debruler, MA

  • Mental Health Counselor
  • Clermont, FL
National Provider Identifier
1073012944
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
20377 Issued in FL
Practice address
1050 US Highway 27 Ste 9
Clermont, FL 34714-7508
Phone
(352) 394-0573
NPI assigned
Feb 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 20377 FL Primary
Behavior Technician 106S00000X VA

Addresses

Primary practice location

1050 US Highway 27 Ste 9
Clermont, FL 34714-7508

Mailing address

21600 Oxnard St Ste 1800
Woodland Hills, CA 91367-7807
Phone (818) 345-2345

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
I20240610003657 FL Practitioner - Mental Health Counselor 4183166804 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
20377FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Health Partners, Inc. CurrentSince Jun 3, 2024 Accepting new patients
Neumind Wellness Group LLC PastSince May 16, 2021 Accepting new patients

Locations

1800 Mercy Dr
Orlando, FL 32808
Phone (407) 295-5151

5151 Adanson St
Ste 201
Orlando, FL 32804
Phone (407) 494-1509

Organizations & group practices 2

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": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1073012944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 OXNARD ST STE 1800",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913677807",
            "telephone_number": "818-345-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 US HIGHWAY 27 STE 9",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347147508",
            "telephone_number": "352-394-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBRULER",
        "first_name": "AUDREY",
        "middle_name": "DORIS",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-06",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "20377",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.