Individual provider Active NPI

Charnell Benjamin-Carter, LMHC

  • Mental Health Counselor
  • Riverview, FL
National Provider Identifier
1225375413
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH-17419 Issued in FL
Practice address
10305 Boggy Moss Dr
Riverview, FL 33578-9503
Phone
(813) 205-0079
NPI assigned
Jan 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X
Mental Health Counselor 101YM0800X MH-17419 FL Primary

Addresses

Primary practice location

10305 Boggy Moss Dr
Riverview, FL 33578-9503

Mailing address

10305 Boggy Moss Dr
Riverview, FL 33578-9503
Phone (813) 205-0079

Other identifiers 2

IdentifierTypeStateIssuer
B525100736800OtherFLDRIVER LICENSE NUMBER
C636-102-73-680-0OtherFLDRIVER LICENSE NUMBER

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10305 Boggy Moss Dr
Riverview, FL 33578-9503

535 Mack Ave
Kingsley, MI 49649-9220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH-17419FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Florida United Methodist Childrens Home, Inc. PastSince Feb 23, 2020 Accepting new patients
Circle of Friends Services Inc PastSince Nov 1, 2019 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1225375413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10305 BOGGY MOSS DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335789503",
            "telephone_number": "813-205-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10305 BOGGY MOSS DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335789503",
            "telephone_number": "813-205-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN-CARTER",
        "first_name": "CHARNELL",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-09",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH-17419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE NUMBER",
            "identifier": "B525100736800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE NUMBER",
            "identifier": "C636-102-73-680-0",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

Verify at the official NPI Registry.