Individual provider Active NPI

Michael Andrew Bryant, MSW, LCSW

  • Mental Health Counselor
  • Clermont, FL
National Provider Identifier
1366068298
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW19990 Issued in FL
Practice address
16126 Magnolia Hill St
Clermont, FL 34714-4907
Phone
(407) 577-8571
NPI assigned
Jun 16, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 14668 FL
Mental Health Counselor 101YM0800X SW19990 FL Primary

Addresses

Primary practice location

16126 Magnolia Hill St
Clermont, FL 34714-4907

Mailing address

16126 Magnolia Hill St
Clermont, FL 34714-4907
Phone (407) 577-8571

Other practice location 1

725 N 12th Ave Bldg B
Arcadia, FL 34266-8752
Phone (863) 494-1242

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
I20220902000011 FL Practitioner - Clinical Social Worker 8820472269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Florida State University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Wellbeing LLCGroup PAC ID 5193021848, 228 clinicians

Practice addresses (Care Compare)

3200 SW 34TH Ave
Suite 701
Ocala, FL 34474-8443
Phone (877) 779-2429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW19990FLMDMental Health Counselor
14668FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
MCR Health, Inc. CurrentSince Sep 6, 2022 Accepting new patients
MCR Health, Inc. CurrentSince Sep 6, 2022 Accepting new patients
Balanced Wellbeing LLC Clinical CurrentSince Aug 8, 2022 Accepting new patients

Locations

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

3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200

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

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1366068298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16126 MAGNOLIA HILL ST",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347144907",
            "telephone_number": "407-577-8571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16126 MAGNOLIA HILL ST",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347144907",
            "telephone_number": "407-577-8571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 N 12th Ave Bldg B",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "FL",
            "postal_code": "342668752",
            "country_code": "US",
            "telephone_number": "863-494-1242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "MICHAEL ANDREW",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-16",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "14668",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW19990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.