Eric Lanham

Individual provider Active NPI Mental Health Counselor · Micanopy, FL

NPI 1174280705 · NPPES record last updated Nov 18, 2021

Key facts

NPI
1174280705
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
22157 NW 87TH Avenue Rd
Micanopy, FL 32667-7439
Phone
(502) 299-2282
NPI assigned
Nov 18, 2021
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250512001954 FL Practitioner - Mental Health Counselor 7113444233 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health Current
since Apr 9, 2025
Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

22157 NW 87TH Avenue Rd
Micanopy, FL 32667-7439

Mailing address

22157 NW 87TH Avenue Rd
Micanopy, FL 32667-7439
Phone (502) 299-2282

Other providers in Micanopy, FL

All providers in Micanopy, FL · Mental Health Counselor in Florida

Sources for this page

Verify at the official NPI Registry.