Ronda Maria Bostick, LMHC
Individual provider Active NPI Mental Health Counselor · Bunnell, FL
NPI 1366033763 · NPPES record last updated Jan 28, 2021
Key facts
- NPI
- 1366033763
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- MH18820 (FL)
- Practice address
- 301 Justice LN
Bunnell, FL 32110-4487 - Phone
- (800) 539-4228
- Fax
- (386) 236-3162
- NPI assigned
- Jan 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240122001521 | FL | Practitioner - Mental Health Counselor | 2860844214 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH18820 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sma Healthcare Inc | Current |
Accepting new patients | |
| Sma Healthcare, Inc | Current |
Accepting new patients | |
| Outreach Community Care Network, Inc. | Past | Accepting new patients | |
| Sma Healthcare Inc | Past | Accepting new patients |
Locations
301 Justice Ln
Bunnell, FL 32110
Phone (386) 236-1726
1150 Red John Dr
Daytona Beach, FL 32124
Phone (386) 236-3183
150 Magnolia Ave
Daytona Beach, FL 32114
Phone (386) 236-3215
3875 Tiger Bay Rd
Daytona Beach, FL 32124
Phone (386) 947-1328
702 S Ridgewood Ave
Daytona Beach, FL 32114
Phone (386) 254-1211
1220 Willis Ave
Daytona Beach, FL 32114
Phone (386) 236-3200
356 Englenook Dr
Ste 142
Debary, FL 32713
105 W Calvin St
Deland, FL 32720
Phone (386) 254-1100
1251 N Stone St
Deland, FL 32720
Phone (386) 469-1544
330 Kay Larkin Dr
Palatka, FL 32177
Phone (386) 329-3780
1880 San Sebastian Vw
Ste 4201
St Augustine, FL 32084
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH18820 | FL | Yes |
Addresses
Primary practice location
301 Justice LN
Bunnell, FL 32110-4487
Mailing address
150 Magnolia Ave
Daytona Beach, FL 32114-4304
Phone (386) 236-3200
Other providers in Bunnell, FL
- Monique M. Berces-Mardenly
- Frances Elizabeth Bey
- Stephen R. Bickel
- Kristina H Blanchek
- Andrew Bliss
- Martha Bradley
- Mary Anna Buckner
- Bunnell Medical Center Inc
- Bunnell Pharmacy Inc
- Carlisi Chiropractic Center Inc.
All providers in Bunnell, FL · Mental Health Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.