Active NPI
Rosemarie Manzolillo, LMHC
- Mental Health Counselor
- Daytona Beach, FL
National Provider Identifier
1407196710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH1833
- Practice address
- 841 Jimmy Ann Dr
Daytona Beach, FL 32117-4583 - Phone
- (386) 425-3900
- Fax
- (386) 274-4140
- NPI assigned
- Feb 22, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LMHC | ||
| Mental Health Counselor | 101YM0800X | MH1833 | FL | Primary |
Addresses
Primary practice location
841 Jimmy Ann Dr
Daytona Beach, FL 32117-4583
Mailing address
118 Star Shell Dr
Apollo Beach, FL 33572-3514
Phone (386) 931-1822
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
Lake Worth, FL 33461
Phone (323) 205-7088
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Specialty Group PA | Mental Health | Current | Accepting new patients |
Locations
2328 10th Ave N
Ste 201
Lake Worth, FL 33461
Phone (561) 236-7622
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": "1361491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723593600000",
"number": "1407196710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 STAR SHELL DR",
"city": "APOLLO BEACH",
"state": "FL",
"postal_code": "335723514",
"telephone_number": "386-931-1822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "841 JIMMY ANN DR",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321174583",
"telephone_number": "386-425-3900",
"fax_number": "386-274-4140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANZOLILLO",
"first_name": "ROSEMARIE",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-22",
"last_updated": "2024-08-14",
"certification_date": "2024-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": "LMHC",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH1833",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.