Individual provider Active NPI

Elmalisa Montalvo, LMHC, MS

  • Mental Health Counselor
  • Orlando, FL
National Provider Identifier
1265980973
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH17764 Issued in FL
Practice address
1701 W Wetherbee Rd Unit 770152
Orlando, FL 32877-7508
Phone
(407) 504-7320
NPI assigned
Sep 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 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 MH17764 FL Primary

Addresses

Primary practice location

1701 W Wetherbee Rd Unit 770152
Orlando, FL 32877-7508

Mailing address

1701 W Wetherbee Rd Unit 770152
Orlando, FL 32877-7508
Phone (407) 504-7320

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
I20240507004314 FL Practitioner - Mental Health Counselor 6507207651 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MH17764FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Mar 27, 2024 Accepting new patients

Locations

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

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": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1265980973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W WETHERBEE RD UNIT 770152",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328777508",
            "telephone_number": "407-504-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W WETHERBEE RD UNIT 770152",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328777508",
            "telephone_number": "407-504-7320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTALVO",
        "first_name": "ELMALISA",
        "name_prefix": "Ms.",
        "credential": "LMHC, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.