Individual provider Active NPI

Connie Porter-Richard, LMHC

  • Mental Health Counselor
  • Rockledge, FL
National Provider Identifier
1215987136
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH3802 Issued in FL
Practice address
845 Executive LN
Suite 100
Rockledge, FL 32955-3528
Phone
(321) 631-5538
Fax
(321) 631-5154
NPI assigned
May 11, 2006
Last updated
Mar 24, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH3802 FL Primary

Addresses

Primary practice location

845 Executive LN
Suite 100
Rockledge, FL 32955-3528

Mailing address

PO Box 560875
Rockledge, FL 32956-0875
Phone (321) 631-5538

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

LicenseStateTypeSpecialty
MH3802FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Discovery Institute, P.a. Mental Health Past Accepting new patients
Marilyn Bennett, LMHC Mental Health Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1215987136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560875",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329560875",
            "telephone_number": "321-631-5538",
            "fax_number": "321-631-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 EXECUTIVE LN",
            "address_2": "SUITE 100",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553528",
            "telephone_number": "321-631-5538",
            "fax_number": "321-631-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER-RICHARD",
        "first_name": "CONNIE",
        "name_prefix": "Dr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH3802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.