Individual provider Active NPI

Nisha Denise Antoine

  • Mental Health Counselor
  • Deerfield Beach, FL
National Provider Identifier
1255006748
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH24607 Issued in FL
Practice address
505 S Federal Hwy
Deerfield Beach, FL 33441-4109
Phone
(954) 421-6242
NPI assigned
Aug 16, 2021
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 MH24607 FL Primary

Addresses

Primary practice location

505 S Federal Hwy
Deerfield Beach, FL 33441-4109

Mailing address

1333 College Pkwy # 1018
Gulf Breeze, FL 32563-2711
Phone (405) 926-7614

Other practice location 1

1333 College Pkwy # 1018
Gulf Breeze, FL 32563-2711
Phone (405) 926-7614

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
I20250124003624 FL Practitioner - Mental Health Counselor 9830628569 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH24607FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Dec 24, 2024 Accepting new patients
Genesis Counseling & Consulting, Inc. Mental Health CurrentSince Sep 1, 2025 Accepting new patients
Clear Journey Counseling Mental Health Past Accepting new patients

Locations

6971 N Federal Hwy
Ste 206
Boca Raton, FL 33487
Phone (561) 408-1098

3000 NW 101st Ln
Ste 202
Coral Springs, FL 33065
Phone (561) 320-2232

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 3

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": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1255006748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 COLLEGE PKWY # 1018",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325632711",
            "telephone_number": "405-926-7614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S FEDERAL HWY",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334414109",
            "telephone_number": "954-421-6242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 College Pkwy # 1018",
            "address_purpose": "LOCATION",
            "city": "Gulf Breeze",
            "state": "FL",
            "postal_code": "325632711",
            "country_code": "US",
            "telephone_number": "405-926-7614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTOINE",
        "first_name": "NISHA",
        "middle_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH24607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.