Marc Daniel Whittlesay Jr., LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH16713 Issued in FL

Practice address

5897 Little Leaf CT
Milton, FL 32570-3501

Phone

(850) 490-7829

NPI assigned

Feb 7, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

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.

• Mindful Heart Organization Inc

  • Community Health Worker
  • Milton, FL
  • NPI 1609730654
  NPD Authorized official
• Mindful Heart Organization Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milton, FL
  • NPI 1871240317
  NPD Authorized official

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1124772413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5897 LITTLE LEAF CT",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325703501",
            "telephone_number": "850-490-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5897 LITTLE LEAF CT",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325703501",
            "telephone_number": "850-490-7829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTLESAY",
        "first_name": "MARC",
        "middle_name": "DANIEL",
        "name_suffix": "Jr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annmarie Terese Whithed, PSY.D.
• Dasia Marie Whiting
• Tabitha Whitley
• Matthew John Whitlock
• Jan Whitney, RN
• Charity Wielander
• Amie Marie Williams, PH.D.
• Gloria A Williams, LPTA
• Lisa Marie Williams, ARNP
• Melissa Williams

• Mental Health Counselor in Milton, FL
• Providers in Milton, 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 Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.