Michele Kay Wiersma, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH6062 Issued in FL

Practice address

505 Brevard Ave Ste 106
Cocoa, FL 32922-7973

Phone

(213) 632-5792

NPI assigned

Jun 4, 2009

Last updated

Jun 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Children's Home Society of Florida

  • Clinic/Center
  • Melbourne, FL
  • NPI 1619445087
  NPD (past)
• Childrens Home Society

  • Community/Behavioral Health Agency
  • Melbourne, FL
  • NPI 1750647657
  NPD (past)

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1295961209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 BREVARD AVE STE 106",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227973",
            "telephone_number": "213-632-5792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 BREVARD AVE STE 106",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227973",
            "telephone_number": "213-632-5792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERSMA",
        "first_name": "MICHELE",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH6062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber White, RN
• Richard L White, PTA
• Carolyn Louise Whiting
• Sierra Whitney
• Lauren Nicole Whittaker
• Temika Wilcox
• Carl Clinton Wilkinson III, D.M.D.
• Sheryl Willhite, RBT
• Tiffany Williams-Brown, NURSE PRACTITIONER
• Alexis Williams

• Mental Health Counselor in Cocoa, FL
• Providers in Cocoa, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.