Active NPI
Shelly Watts
- Professional Counselor
- Orlando, FL
National Provider Identifier
1396102448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- MH8456
- Practice address
- 422 S Alafaya TRL Ste 17
Orlando, FL 32828-8984 - Phone
- (407) 275-0745
- Fax
- (407) 275-0829
- NPI assigned
- Jan 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | MH8456 | FL | Primary |
Addresses
Primary practice location
422 S Alafaya TRL Ste 17
Orlando, FL 32828-8984
Mailing address
422 S Alafaya Trail 17
Orlando, FL 32828
Phone (407) 275-0745
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH8456 | FL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychiatric Group of Orlando PA | Past | Accepting new patients |
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.
-
- Psychiatry Physician
- Orlando, FL
- NPI 1134130768
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453248000000",
"number": "1396102448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "422 S ALAFAYA TRAIL 17",
"city": "ORLANDO",
"state": "FL",
"postal_code": "32828",
"telephone_number": "407-275-0745",
"fax_number": "407-275-0829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "422 S ALAFAYA TRL STE 17",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328288984",
"telephone_number": "407-275-0745",
"fax_number": "407-275-0829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "SHELLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-20",
"last_updated": "2016-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "FL",
"license": "MH8456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.