Dustin Ernest Baetz

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH21933 Issued in FL

Practice address

2290 N Ronald Reagan Blvd Ste 116
Longwood, FL 32750-3534

Phone

(407) 215-0095

NPI assigned

Jun 23, 2021

Last updated

Oct 17, 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)

Enrolled

State licenses

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792195200000",
    "number": "1174192173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GENERAL DELIVERY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328029999",
            "telephone_number": "347-229-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 N RONALD REAGAN BLVD STE 116",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503534",
            "telephone_number": "407-215-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAETZ",
        "first_name": "DUSTIN",
        "middle_name": "ERNEST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-23",
        "last_updated": "2026-10-17",
        "certification_date": "2026-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH21933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Longwood, FL
• Providers in Longwood, 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 Oct 17, 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.