Individual provider Active NPI

Katelin Monnik, LMHC

  • Mental Health Counselor
  • Lakeland, FL
National Provider Identifier
1497240147
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH22172 Issued in FL
Practice address
1664 Williamsburg SQ
Lakeland, FL 33803-4278
Phone
(863) 519-0575
NPI assigned
Jun 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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 MH22172 FL Primary

Addresses

Primary practice location

1664 Williamsburg SQ
Lakeland, FL 33803-4278

Mailing address

PO Box 1559
Bartow, FL 33831-1559

Other identifiers 1

IdentifierTypeStateIssuer
118246100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH22172FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peace River Center for Personal Development Inc CurrentSince May 28, 2023 Accepting new patients
Peace River Center for Personal Development Inc PastSince Apr 17, 2022 Accepting new patients

Locations

1239 E Main St
Bartow, FL 33830
Phone (863) 533-8111

1664 Williamsburg Sq
Lakeland, FL 33803
Phone (863) 316-5498

Organizations & group practices 2

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": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1497240147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338311559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 WILLIAMSBURG SQ",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034278",
            "telephone_number": "863-519-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONNIK",
        "first_name": "KATELIN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH22172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118246100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.