Active NPI
Wendy Eldredge, MA, RMHCI
- Mental Health Counselor
- Cocoa, FL
National Provider Identifier
1104446665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH20110
- Practice address
- 505 Brevard Ave Ste 106
Cocoa, FL 32922-7973 - Phone
- (321) 872-7354
- NPI assigned
- Apr 24, 2020
- Sex
- Female
- Sole proprietor
- No
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 | IMH18232 | FL | |
| Mental Health Counselor | 101YM0800X | MH20110 | FL | Primary |
Addresses
Primary practice location
505 Brevard Ave Ste 106
Cocoa, FL 32922-7973
Mailing address
485 West Rd Apt 2
Merritt Island, FL 32952-4900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMH18232 | FL | MD | Mental Health Counselor |
| MH20110 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641340800000",
"number": "1104446665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "485 WEST RD APT 2",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329524900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 BREVARD AVE STE 106",
"city": "COCOA",
"state": "FL",
"postal_code": "329227973",
"telephone_number": "321-872-7354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDREDGE",
"first_name": "WENDY",
"credential": "MA, RMHCI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-24",
"last_updated": "2022-01-05",
"certification_date": "2022-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMH18232",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH20110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cocoa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.