Individual provider Active NPI

Kevin Wernham, LMHC

  • Mental Health Counselor
  • Lake Mary, FL
National Provider Identifier
1104457761
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH23679 Issued in FL
Practice address
525 Technology Park Ste 109
Lake Mary, FL 32746-7107
Phone
(407) 647-2346
NPI assigned
Jan 31, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MH23679 FL Primary

Addresses

Primary practice location

525 Technology Park Ste 109
Lake Mary, FL 32746-7107

Mailing address

11850 Cross Vine Dr
Riverview, FL 33579-4300
Phone (813) 679-0548

Other practice location 1

11850 Cross Vine Dr
Riverview, FL 33579-4300
Phone (813) 679-0548

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
I20250304003858 FL Practitioner - Mental Health Counselor 6305367533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Luisa Vega DNP LLCGroup PAC ID 3577872605, 83 clinicians

Practice addresses (Care Compare)

1044 E Brandon Blvd
Suite 1And2
Brandon, FL 33511-5509
Phone (813) 403-4423

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
IMH15724FLMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Luisa Vega DNP LLC Single Specialty CurrentSince Feb 1, 2025 Accepting new patients

Locations

1044 E Brandon Blvd
Ste 12
Brandon, FL 33511
Phone (813) 403-4423

525 Technology Park
Lake Mary, FL 32746
Phone (407) 347-4331

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

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": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1104457761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11850 CROSS VINE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335794300",
            "telephone_number": "813-679-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 TECHNOLOGY PARK STE 109",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467107",
            "telephone_number": "407-647-2346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11850 Cross Vine Dr",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335794300",
            "country_code": "US",
            "telephone_number": "813-679-0548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WERNHAM",
        "first_name": "KEVIN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-31",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH23679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.