Jack Adam Fasteen

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

27226 Issued in FL

Practice address

200 S Harbor City Blvd Ste 401
Melbourne, FL 32901-1389

Phone

(321) 259-1662

Fax

(321) 779-7729

NPI assigned

Aug 20, 2026

Last updated

Aug 20, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1787184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1164338265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S HARBOR CITY BLVD STE 401",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011389",
            "telephone_number": "321-259-1662",
            "fax_number": "321-779-7729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S HARBOR CITY BLVD STE 401",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011389",
            "telephone_number": "321-259-1662",
            "fax_number": "321-779-7729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8249 Devereux Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Viera",
            "state": "FL",
            "postal_code": "329407955",
            "country_code": "US",
            "telephone_number": "321-259-1662 x2",
            "fax_number": "321-779-7729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FASTEEN",
        "first_name": "JACK",
        "middle_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-20",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "27226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Melbourne, FL
• Providers in Melbourne, 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 Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.