Melissa M Clendaniel, MS, NCC, LACMH

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

AC-0000143

Practice address

400 Midway Dr
Rehoboth Beach, DE 19971-9639

Phone

(302) 249-0754

NPI assigned

Sep 30, 2019

Sex

Female

Sole proprietor

No

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.

• State of Mind Counseling Services, LLC

  • Mental Health Counselor
  • Milford, DE
  • NPI 1275260952

  DE, Mental Health

  Medicare reassignment Care Compare group NPD

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of Mind Counseling Services, LLC 13 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in DE

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 30, 2019.

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1427699552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MIDWAY DR",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199719639",
            "telephone_number": "302-249-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MIDWAY DR",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199719639",
            "telephone_number": "302-249-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLENDANIEL",
        "first_name": "MELISSA",
        "middle_name": "M",
        "credential": "MS, NCC, LACMH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "AC-0000143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Peter B Collis, MD

• All providers in Rehoboth Beach, DE
• Mental Health Counselor in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.