Individual provider Active NPI

Myralda Jerome, LMHC

  • Mental Health Counselor
  • Port St Lucie, FL
National Provider Identifier
1235687369
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH19806 Issued in FL
Practice address
2100 SE Hillmoor Dr Ste 201
Port St Lucie, FL 34952-8057
Phone
(561) 908-1336
NPI assigned
Sep 19, 2016
Last updated
Dec 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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 MH19806 FL Primary

Addresses

Primary practice location

2100 SE Hillmoor Dr Ste 201
Port St Lucie, FL 34952-8057

Mailing address

1205 SW Emerald Ave
Port Saint Lucie, FL 34953-4810
Phone (561) 908-1336

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
I20260430000310 FL Practitioner - Mental Health Counselor 4385111038 Practice locations: Port St Lucie, FL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1205 SW Emerald Ave
Port St Lucie, FL 34953-4810

2100 SE Hillmoor Dr
Suite 201
Port St Lucie, FL 34952-8057
Phone (561) 908-1336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH19806FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1235687369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 SW EMERALD AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349534810",
            "telephone_number": "561-908-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SE HILLMOOR DR STE 201",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349528057",
            "telephone_number": "561-908-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEROME",
        "first_name": "MYRALDA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH19806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.