Individual provider Active NPI

Heather Proctor, LMHC

  • Mental Health Counselor
  • North Port, FL
National Provider Identifier
1477085439
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH13422 Issued in FL
Practice address
2571 N Toledo Blade Blvd Unit 3
North Port, FL 34289
Phone
(941) 276-6716
NPI assigned
Mar 29, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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 MH13422 FL Primary

Addresses

Primary practice location

2571 N Toledo Blade Blvd Unit 3
North Port, FL 34289

Mailing address

2571 N Toledo Blade Blvd Unit 3
North Port, FL 34289-9351
Phone (941) 276-6716

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
I20240419003074 FL Practitioner - Mental Health Counselor 2860752532 Practice locations: Port Charlotte, FL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1720 El Jobean Rd
Unit 109
Port Charlotte, FL 33948-1286
Phone (941) 276-6716

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH13422FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1477085439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2571 N TOLEDO BLADE BLVD UNIT 3",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342899351",
            "telephone_number": "941-276-6716",
            "fax_number": "941-234-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2571 N TOLEDO BLADE BLVD UNIT 3",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "34289",
            "telephone_number": "941-276-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "HEATHER",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Port, FL

Sources for this page

Verify at the official NPI Registry.