Individual provider Active NPI

Cristina Mejia-Millan, PH.D.

  • Psychologist
  • Winter Haven, FL
National Provider Identifier
1194820795
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY6458 Issued in FL
Practice address
635 1St St N
Winter Haven, FL 33881-4129
Phone
(863) 294-0670
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY6458 FL Primary

Addresses

Primary practice location

635 1St St N
Winter Haven, FL 33881-4129

Mailing address

635 1St St N
Winter Haven, FL 33881-4129

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
I20050216000573 FL Practitioner - Clinical Psychologist 6608834817 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Che Behavioral Health Services of Florida, P.a.Group PAC ID 5698185775, 31 clinicians

Practice addresses (Care Compare)

6750 N Andrews Ave
Suite 200
Ft Lauderdale, FL 33309-2180
Phone (888) 515-3834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY6458FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Current Accepting new patients
Che Behavioral Health Services of Florida, P.a. CurrentSince Jan 20, 2024 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Dec 2, 2023 Accepting new patients
Gessler Clinic Professional Association CurrentSince Oct 27, 2020 Accepting new patients
GPS II Past Accepting new patients
John P McDonough III Psychologist PastSince Oct 1, 2004 Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

6750 N Andrews Ave
Ste 200
Lauderdale Lakes, FL 33309
Phone (718) 408-5477

101 Avenue D NW
Winter Haven, FL 33881
Phone (863) 294-3526

635 1st St N
Winter Haven, FL 33881
Phone (863) 294-0670

Networks

  • Freedom Health HMO Network

Organizations & group practices 6

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1194820795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 1ST ST N",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 1ST ST N",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814129",
            "telephone_number": "863-294-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA-MILLAN",
        "first_name": "CRISTINA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.