Kathleen Harriet Wakefield, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH5306 Issued in FL

Practice address

125 Poquito Rd
Shalimar, FL 32579-1126

Phone

(850) 240-2212

Fax

(850) 651-4292

NPI assigned

Sep 28, 2006

Sex

Female

Sole proprietor

Yes

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

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

Specialty

Mental Health Counselor

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bluewater Behavioral Health, Inc.Group PAC ID 3274873435, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bluewater Behavioral Health Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Niceville, FL
  • NPI 1922562628
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386736296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 POQUITO RD",
            "city": "SHALIMAR",
            "state": "FL",
            "postal_code": "325791126",
            "telephone_number": "850-240-2212",
            "fax_number": "850-651-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 POQUITO RD",
            "city": "SHALIMAR",
            "state": "FL",
            "postal_code": "325791126",
            "telephone_number": "850-240-2212",
            "fax_number": "850-651-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEFIELD",
        "first_name": "KATHLEEN",
        "middle_name": "HARRIET",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH5306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Caryn Valcourt
• Norene M Vello, LPCC
• Jamie P Von Barnau Sythoff, BCABA
• Natasha Vosburgh
• Wendy Vrijbloed, DDS
• Holly A Ward, MD
• Morgan Wasik
• Amanda Weber, CCC SLP
• Janie M. Weeks-Long, CRNA
• Colleen Wenner-Foy, MA LMHC. MCAP

• Mental Health Counselor in Shalimar, FL
• Providers in Shalimar, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.