Melissa Lee Georgopolis, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH6910 Issued in FL

Practice address

5800 20TH Ave S
Gulfport, FL 33707-4050

Phone

(727) 344-7646

NPI assigned

Nov 2, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Melissa Lee Georgopolis Kerley Other name

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

Specialty

Mental Health Counselor

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Emerald Clover, LLCGroup PAC ID 5496290033, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Emerald Clover, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Petersburg, FL
  • NPI 1972218055
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1467964270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 20TH AVE S",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "337074050",
            "telephone_number": "727-344-7646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 20TH AVE S",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "337074050",
            "telephone_number": "727-344-7646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 Florida Ave",
            "address_purpose": "LOCATION",
            "city": "Palm Harbor",
            "state": "FL",
            "postal_code": "346834312",
            "country_code": "US",
            "telephone_number": "727-255-9230",
            "fax_number": "727-259-2305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5800 20th Ave S",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "FL",
            "postal_code": "337074050",
            "country_code": "US",
            "telephone_number": "727-344-7646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGOPOLIS",
        "first_name": "MELISSA",
        "middle_name": "LEE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-02",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH6910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022830900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "GEORGOPOLIS KERLEY",
            "middle_name": "LEE",
            "credential": "LMHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Mental Health Counselor in Gulfport, FL
• Providers in Gulfport, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.