Individual provider Active NPI

Elise Powell, LMHC

  • Mental Health Counselor
  • Lantana, FL
National Provider Identifier
1073796983
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 8498 Issued in FL
Practice address
6788 Massachusetts Dr
Suite #1
Lantana, FL 33462-3836
Phone
(561) 670-7839
NPI assigned
Dec 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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 8498 FL Primary

Addresses

Primary practice location

6788 Massachusetts Dr
Suite #1
Lantana, FL 33462-3836

Mailing address

6788 Massachusetts Dr
Suite #1
Lantana, FL 33462-3836
Phone (561) 670-7839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • 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
I20240807000984 FL Practitioner - Mental Health Counselor 7618414780 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH 8498FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Moon Senior Counseling CurrentSince Jun 20, 2024 Accepting new patients

Locations

2057 Edgewater Dr
Clearwater, FL 33755
Phone (727) 205-7077

15520 NW 2nd Ave
North Miami Beach, FL 33169
Phone (305) 949-2626

10204 Bode St
Ste B
Plainfield, IL 60585
Phone (630) 229-6462

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1073796983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6788 MASSACHUSETTS DR",
            "address_2": "SUITE #1",
            "city": "LANTANA",
            "state": "FL",
            "postal_code": "334623836",
            "telephone_number": "561-670-7839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6788 MASSACHUSETTS DR",
            "address_2": "SUITE #1",
            "city": "LANTANA",
            "state": "FL",
            "postal_code": "334623836",
            "telephone_number": "561-670-7839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "ELISE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 8498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lantana, FL

Sources for this page

Verify at the official NPI Registry.