Active NPI
Casandra Merritt
- Mental Health Counselor
- Brandon, FL
National Provider Identifier
1205239357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- IMH 12768
- Practice address
- 135 N Moon Ave
Brandon, FL 33510-4419 - Phone
- (813) 489-4547
- Fax
- (813) 381-5140
- NPI assigned
- Oct 3, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | CBHCMS100611 | FL | |
| Mental Health Counselor | 101YM0800X | IMH 12768 | FL | Primary |
Addresses
Primary practice location
135 N Moon Ave
Brandon, FL 33510-4419
Mailing address
135 N Moon Ave
Brandon, FL 33510-4419
Phone (813) 489-4547
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMH 12768 | FL | MD | Mental Health Counselor |
| CBHCMS100611 | FL | MD | Case Manager/Care Coordinator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Start Fresh Counseling Center, Inc | Mental Health | Current | Accepting new patients |
| New Journey Counseling Center LLC | Mental Health | Current | Accepting new patients |
Locations
135 N Moon Ave
Brandon, FL 33510
Phone (813) 489-4547
1463 Oakfield Dr
Ste 117
Brandon, FL 33511
Phone (813) 489-4547
Organizations & group practices 2
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.
-
- Mental Health Counselor
- Brandon, FL
- NPI 1285515452
-
- Mental Health Counselor
- Brandon, FL
- NPI 1376930362
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644451200000",
"number": "1205239357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 N MOON AVE",
"city": "BRANDON",
"state": "FL",
"postal_code": "335104419",
"telephone_number": "813-489-4547",
"fax_number": "813-381-5140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 N MOON AVE",
"city": "BRANDON",
"state": "FL",
"postal_code": "335104419",
"telephone_number": "813-489-4547",
"fax_number": "813-381-5140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRITT",
"first_name": "CASANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-03",
"last_updated": "2022-02-10",
"certification_date": "2022-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "FL",
"license": "CBHCMS100611",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMH 12768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.