Individual provider Active NPI

Brie-Anna Michelle Willey, L.M.H.C., C.R.C.

  • Mental Health Counselor
  • Palmetto, FL
National Provider Identifier
1376910059
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH12927 Issued in FL
Practice address
600 8TH Ave W Ste 200
Palmetto, FL 34221-5162
Phone
(941) 757-8597
Fax
(855) 240-3641
NPI assigned
Aug 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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 MH12927 FL Primary

Addresses

Primary practice location

600 8TH Ave W Ste 200
Palmetto, FL 34221-5162

Mailing address

PO Box 2063
Palmetto, FL 34220-2063
Phone (941) 807-2670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2024 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH12927FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Shekinah Counseling and Consulting LLC Mental Health CurrentSince Mar 1, 2020 Accepting new patients

Locations

600 8th Ave W
Ste 200
Palmetto, FL 34221
Phone (301) 806-6948

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": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1376910059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2063",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342202063",
            "telephone_number": "941-807-2670",
            "fax_number": "855-240-3641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 8TH AVE W STE 200",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342215162",
            "telephone_number": "941-757-8597",
            "fax_number": "855-240-3641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLEY",
        "first_name": "BRIE-ANNA",
        "middle_name": "MICHELLE",
        "credential": "L.M.H.C., C.R.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-28",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto, FL

Sources for this page

Verify at the official NPI Registry.