Individual provider Active NPI

Melissa Yvette Brown

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1558800516
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH 12903 Issued in FL
Practice address
1511 Goodwin St
Jacksonville, FL 32204-3813
Phone
(904) 536-7195
Fax
(844) 364-8553
NPI assigned
Feb 22, 2017
Last updated
Jun 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 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 IMH 12903 FL Primary

Addresses

Primary practice location

1511 Goodwin St
Jacksonville, FL 32204-3813

Mailing address

1511 Goodwin St
Jacksonville, FL 32204-3813
Phone (904) 536-7195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA, DC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20240528002296 FL Practitioner - Mental Health Counselor 0345682993 Reassigns benefits to 1 organization
I20240705001158 GA Practitioner - Mental Health Counselor 0345682993 Reassigns benefits to 1 organization
I20260407001570 DC Practitioner - Mental Health Counselor 0345682993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IMH 12903FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Melissa Brown LMHC LLC Mental Health CurrentSince Sep 11, 2022 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Apr 16, 2024 Accepting new patients

Locations

1511 Goodwin St
Jacksonville, FL 32204
Phone (904) 236-8344

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1558800516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 GOODWIN ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043813",
            "telephone_number": "904-536-7195",
            "fax_number": "844-364-8553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 GOODWIN ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043813",
            "telephone_number": "904-536-7195",
            "fax_number": "844-364-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MELISSA",
        "middle_name": "YVETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH 12903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.