Individual provider Active NPI

Lucas Todd Kockler, LMHC

  • Mental Health Counselor
  • Daytona Beach, FL
National Provider Identifier
1477149201
Registry record updated Apr 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
140 S Beach St Ste 310
Daytona Beach, FL 32114-4409
Phone
(386) 968-2500
NPI assigned
Dec 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH23680 FL
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

140 S Beach St Ste 310
Daytona Beach, FL 32114-4409

Mailing address

7045 30TH Ave N Apt 25
St Petersburg, FL 33710-3047
Phone (630) 740-9678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH23680FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714262400000",
    "number": "1477149201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7045 30TH AVE N APT 25",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337103047",
            "telephone_number": "630-740-9678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 S BEACH ST STE 310",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144409",
            "telephone_number": "386-968-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCKLER",
        "first_name": "LUCAS",
        "middle_name": "TODD",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-16",
        "last_updated": "2024-04-28",
        "certification_date": "2024-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH23680",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.