Individual provider Active NPI

Andrea Lynn Coverman, PSYD, CADAC, CAP

  • Psychologist
  • Merritt Island, FL
National Provider Identifier
1255759338
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY9851 Issued in FL
Practice address
1475 Mercury St
Merritt Island, FL 32953-3122
Phone
(407) 252-4884
Fax
(407) 252-4884
NPI assigned
Apr 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1500 SC
Psychologist 103T00000X PY9851 FL Primary

Addresses

Primary practice location

1475 Mercury St
Merritt Island, FL 32953-3122

Mailing address

1475 Mercury St
Merritt Island, FL 32953-3122
Phone (407) 252-4884

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
I20181119002880 FL Practitioner - Clinical Psychologist 4688928120 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1500SCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
MCR Health, Inc. CurrentSince Nov 2, 2018 Accepting new patients
Mind Body Therapeutics LLC CurrentSince Nov 1, 2023 Accepting new patients
Cotler Healthcare & Development Inc. CurrentSince Aug 1, 2021 Accepting new patients
MCR Health, Inc. CurrentSince Nov 2, 2018 Accepting new patients

Locations

725 N 12th Ave
Bldg B
Arcadia, FL 34266
Phone (863) 494-1242

901 S 62nd Ave
Hollywood, FL 33023
Phone (954) 893-0109

9835 Lake Worth Rd
Ste 16179
Lake Worth, FL 33467

700 8th Ave W
Ste 101
Palmetto, FL 34221
Phone (941) 776-4008

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

2630 SE Willoughby Blvd
#2B
Stuart, FL 34994
Phone (772) 486-4417

2225 Knox McRae Dr
Titusville, FL 32780
Phone (321) 267-0060

Organizations & group practices 4

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": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1255759338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 MERCURY ST",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533122",
            "telephone_number": "407-252-4884",
            "fax_number": "407-252-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 MERCURY ST",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533122",
            "telephone_number": "407-252-4884",
            "fax_number": "407-252-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVERMAN",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSYD, CADAC, CAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-04",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "SC",
            "license": "1500",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY9851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

Verify at the official NPI Registry.