Individual provider Active NPI

Juliana Pryor Menke, LMHC

  • Mental Health Counselor
  • St Petersburg, FL
National Provider Identifier
1215218581
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 9971 Issued in FL
Practice address
1001 16TH St S
St Petersburg, FL 33705-2231
Phone
(727) 327-7656
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 9971 FL Primary
Counselor 101Y00000X MH9971 FL

Addresses

Primary practice location

1001 16TH St S
St Petersburg, FL 33705-2231

Mailing address

1001 16TH St S
St Petersburg, FL 33705-2231
Phone (727) 327-7656

Other identifiers 1

IdentifierTypeStateIssuer
MH 9971MedicaidFL

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
I20231228000149 FL Practitioner - Mental Health Counselor 1153771571 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH9971FLMDCounselor
MH 9971FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

4024 Central Ave
St Petersburg, FL 33711

1001 16th St S
St Petersburg, FL 33705
Phone (727) 242-1775

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.

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1215218581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 16TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337052231",
            "telephone_number": "727-327-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 16TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337052231",
            "telephone_number": "727-327-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENKE",
        "first_name": "JULIANA",
        "middle_name": "PRYOR",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 9971",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH9971",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MH 9971",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.