Donald Fred Willets, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 2300 Issued in FL

Practice address

4951 Southfork Dr
Lakeland, FL 33813

Phone

(863) 614-0034

Fax

(863) 937-0284

NPI assigned

Sep 13, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 25, 2024 through Apr 25, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Lakeland Counseling LLC

  • Mental Health Counselor
  • Lakeland, FL
  • NPI 1326475708
  NPD Authorized official

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1073508305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91872",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33804",
            "telephone_number": "863-614-0034",
            "fax_number": "863-937-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 SOUTHFORK DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33813",
            "telephone_number": "863-614-0034",
            "fax_number": "863-937-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLETS",
        "first_name": "DONALD",
        "middle_name": "FRED",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 2300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC.",
            "identifier": "MH2300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Z Wilcox, LMHE
• Deborah Wilk, COUNSELING
• Kaitlin Elizabeth Wilkes, PA-C
• Kayla Gaschler Wilkins, AU.D.
• Cheza Marie Wilkinson, APRN
• Sherry Elaine Willhoite
• William S Wong, D.P.M. P.a.
• William Vargas, M.D. P. a.
• Williams Quality Healthcare Team LLC
• Ashley Marie Williams, PA-C

• Mental Health Counselor in Lakeland, FL
• Providers in Lakeland, 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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.