Connie Porter-Richard, LMHC

Individual provider Active NPI Mental Health Counselor · Rockledge, FL

NPI 1215987136 · NPPES record last updated Mar 24, 2008

Key facts

NPI
1215987136
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
MH3802 (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
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

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

Specialties & licenses

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

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

Other providers in Rockledge, FL

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

Sources for this page

Verify at the official NPI Registry.