Individual provider Active NPI

Roberta Leah Cavin, MS, LMHC

  • Mental Health Counselor
  • Daytona Beach, FL
National Provider Identifier
1104391101
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH18437 Issued in FL
Practice address
430 Braddock Ave
Daytona Beach, FL 32118-4616
Phone
(407) 415-8908
NPI assigned
Oct 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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 MH18437 FL Primary

Addresses

Primary practice location

430 Braddock Ave
Daytona Beach, FL 32118-4616

Mailing address

1229 Holly Ave
Holly Hill, FL 32117-2715
Phone (407) 415-8908

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
I20240124001437 FL Practitioner - Mental Health Counselor 1153774369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Counseling Center IncGroup PAC ID 8325370950, 10 clinicians

Practice addresses (Care Compare)

121 W Pennsylvania Ave
Deland, FL 32720-3429
Phone (386) 258-1618

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MH18437FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Counseling Center Inc Mental Health CurrentSince Jan 19, 2024 Accepting new patients

Locations

430 Braddock Ave
Daytona Beach, FL 32118
Phone (386) 258-1616

121 W Pennsylvania Ave
Deland, FL 32720
Phone (386) 290-6525

105 Amsden Rd
Ormond Beach, FL 32176

386 S Atlantic Ave
Ormond Beach, FL 32176
Phone (240) 731-6929

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1104391101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 HOLLY AVE",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "321172715",
            "telephone_number": "407-415-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 BRADDOCK AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321184616",
            "telephone_number": "407-415-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVIN",
        "first_name": "ROBERTA",
        "middle_name": "LEAH",
        "credential": "MS, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-05",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH18437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.