Individual provider Active NPI

Michelle Chaffardet

  • Marriage & Family Therapist
  • Cocoa, FL
National Provider Identifier
1265210348
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT4716 Issued in FL
Practice address
126 Highland St
Cocoa, FL 32922-7523
Phone
(305) 970-5519
Fax
(305) 970-5519
NPI assigned
Sep 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy Psychologist 103TP2701X MT4716 FL
Marriage & Family Therapist 106H00000X MT4716 FL Primary
Mental Health Counselor 101YM0800X MT4716 FL
Psychologist 103T00000X MT4716 FL
Adult Development & Aging Psychologist 103TA0700X MT4716 FL
Clinical Child & Adolescent Psychologist 103TC2200X MT4716 FL

Addresses

Primary practice location

126 Highland St
Cocoa, FL 32922-7523

Mailing address

126 Highland St
Cocoa, FL 32922-7523
Phone (305) 970-5519

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
I20231208002075 FL Practitioner - Marriage and Family Therapist 9638528110 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT4716FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Vibewell Therapy CurrentSince Nov 19, 2023 Accepting new patients

Organizations & group practices 1

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": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1265210348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 HIGHLAND ST",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227523",
            "telephone_number": "305-970-5519",
            "fax_number": "305-970-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 HIGHLAND ST",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227523",
            "telephone_number": "305-970-5519",
            "fax_number": "305-970-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAFFARDET",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-19",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "FL",
            "license": "MT4716",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4716",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MT4716",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "MT4716",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "FL",
            "license": "MT4716",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "MT4716",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa, FL

Sources for this page

Verify at the official NPI Registry.