Active NPI
Audrey Doris Debruler, MA
- Mental Health Counselor
- Clermont, FL
National Provider Identifier
1073012944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 20377
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20377 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspire Health Partners, Inc. | Current | Accepting new patients | |
| Neumind Wellness Group LLC | Past | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Orlando, FL
- NPI 1821033903
-
- Community/Behavioral Health Agency
- Clermont, FL
- NPI 1396101697
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.