Individual provider Active NPI

Melissa M Riesgo, LMHC

  • Mental Health Counselor
  • Weston, FL
National Provider Identifier
1487275954
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH13630 Issued in FL
Practice address
2645 Executive Park Dr Ste 149
Weston, FL 33331-3624
Phone
(954) 701-3854
NPI assigned
May 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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 MH13630 FL Primary

Addresses

Primary practice location

2645 Executive Park Dr Ste 149
Weston, FL 33331-3624

Mailing address

16446 NW 14TH St
Pembroke Pines, FL 33028-1314
Phone (954) 701-3854

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
I20250429002040 FL Practitioner - Mental Health Counselor 8628467743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Full Circle Therapy LLCGroup PAC ID 2365968765, 8 clinicians

Practice addresses (Care Compare)

1760 Bell Tower LN
Suite 201
Weston, FL 33326-3644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Full Circle Therapy LLC Mental Health CurrentSince Dec 10, 2024 Accepting new patients

Locations

2645 Executive Park Dr
Weston, FL 33331
Phone (513) 288-5937

1760 Bell Tower Ln
Ste 201
Weston, FL 33326
Phone (954) 684-2915

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1487275954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16446 NW 14TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281314",
            "telephone_number": "954-701-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 EXECUTIVE PARK DR STE 149",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313624",
            "telephone_number": "954-701-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESGO",
        "first_name": "MELISSA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, FL

Sources for this page

Verify at the official NPI Registry.