Individual provider Active NPI

Edn Habte

  • Mental Health Counselor
  • Winter Park, FL
National Provider Identifier
1407306780
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
ISW 7841 Issued in FL
Practice address
3213 Rosebud LN
Apt 14203
Winter Park, FL 32792-8790
Phone
(267) 408-5049
NPI assigned
Oct 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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 ISW 7841 FL Primary

Addresses

Primary practice location

3213 Rosebud LN
Apt 14203
Winter Park, FL 32792-8790

Mailing address

3213 Rosebud LN
Apt 14203
Winter Park, FL 32792-8790

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
I20190603002496 FL Practitioner - Clinical Social Worker 9436482650 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15017 N Dale Mabry Hwy
Suite 1048
Tampa, FL 33618-1816

15017 N Dale Mabry Hwy 1048
Tampa, FL 33618-1816

4139 Brentwood Park Cir
Tampa, FL 33624-1303
Phone (407) 349-7103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW 7841FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Moon Senior Counseling CurrentSince Jan 14, 2020 Accepting new patients
Good Shepherd Psychiatric & Medical Center Inc CurrentSince Jun 25, 2023 Accepting new patients
Counseling Resource Services, Inc. CurrentSince May 16, 2019 Accepting new patients

Locations

9050 Pines Blvd
Ste 427
Pembroke Pines, FL 33024
Phone (916) 299-0958

9050 Pines Blvd
Ste 425427
Pembroke Pines, FL 33024

13350 W Colonial Dr
Ste 340
Winter Garden, FL 34787
Phone (407) 654-4433

10204 Bode St
Ste B
Plainfield, IL 60585
Phone (630) 229-6462

Organizations & group practices 4

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": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1407306780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3213 ROSEBUD LN",
            "address_2": "APT 14203",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327928790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3213 ROSEBUD LN",
            "address_2": "APT 14203",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327928790",
            "telephone_number": "267-408-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABTE",
        "first_name": "EDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "ISW 7841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.