Individual provider Active NPI

Michelle Protko, LMHC

  • Mental Health Counselor
  • Daytona Beach, FL
National Provider Identifier
1497192504
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH13799 Issued in FL
Practice address
841 Jimmy Ann Dr
Daytona Beach, FL 32117-4583
Phone
(386) 425-3945
NPI assigned
May 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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 MH13799 FL Primary

Addresses

Primary practice location

841 Jimmy Ann Dr
Daytona Beach, FL 32117-4583

Mailing address

841 Jimmy Ann Dr
Daytona Beach, FL 32117-4583
Phone (385) 425-3945

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
I20240306004326 FL Practitioner - Mental Health Counselor 2466898986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Counseling Center IncGroup PAC ID 8325370950, 10 clinicians

Practice addresses (Care Compare)

121 W Pennsylvania Ave
Deland, FL 32720-3429
Phone (386) 258-1618

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Counseling Center Inc Mental Health CurrentSince Jan 31, 2024 Accepting new patients

Locations

121 W Pennsylvania Ave
Deland, FL 32720
Phone (386) 290-6525

105 Amsden Rd
Ormond Beach, FL 32176

386 S Atlantic Ave
Ormond Beach, FL 32176
Phone (240) 731-6929

4662 Clyde Morris Blvd
Port Orange, FL 32129
Phone (386) 451-1008

Networks

  • Freedom Health HMO Network

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": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1497192504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 JIMMY ANN DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174583",
            "telephone_number": "385-425-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 JIMMY ANN DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174583",
            "telephone_number": "386-425-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROTKO",
        "first_name": "MICHELLE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.