Individual provider Active NPI

Morgan O'Shaughnessy

  • Mental Health Counselor
  • Melbourne, FL
National Provider Identifier
1407479876
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH15935 Issued in FL
Practice address
100 S Harbor City Blvd
Melbourne, FL 32901-1319
Phone
(321) 266-1404
NPI assigned
May 20, 2020
Last updated
May 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 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 MH15935 FL Primary

Addresses

Primary practice location

100 S Harbor City Blvd
Melbourne, FL 32901-1319

Mailing address

557 Platt Cir
Melbourne, FL 32904-2530
Phone (321) 266-1404

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
I20240402001848 FL Practitioner - Mental Health Counselor 4880032499 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH15935FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Recovery and Wellness Center LLC CurrentSince Feb 20, 2024 Accepting new patients

Locations

1501 Robert J Conlan Blvd NE
Ste 7
Palm Bay, FL 32905
Phone (321) 372-6897

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1407479876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 PLATT CIR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329042530",
            "telephone_number": "321-266-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S HARBOR CITY BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011319",
            "telephone_number": "321-266-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SHAUGHNESSY",
        "first_name": "MORGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH15935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.