Individual provider Active NPI

Vanessa Denise Waszkiewicz, LMHC

  • Mental Health Counselor
  • Palm Bay, FL
National Provider Identifier
1619609435
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH22438 Issued in FL
Practice address
3200 Mockingbird Ave SW
Palm Bay, FL 32908-4900
Phone
(321) 307-3363
NPI assigned
Jun 29, 2022
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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 IMH20665 FL
Mental Health Counselor 101YM0800X MH22438 FL Primary

Addresses

Primary practice location

3200 Mockingbird Ave SW
Palm Bay, FL 32908-4900

Mailing address

3200 Mockingbird Ave SW
Palm Bay, FL 32908-4900
Phone (321) 307-3363

Other practice location 1

4630 Lipscomb St NE Ste 1A
Palm Bay, FL 32905-2940
Phone (321) 405-2583

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
I20240508004138 FL Practitioner - Mental Health Counselor 3870934847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baytree Behavioral Health PAGroup PAC ID 0244298313, 7 clinicians

Practice addresses (Care Compare)

1370 Bedford Dr
Suite 106
Melbourne, FL 32940-1993
Phone (321) 253-8887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IMH20665FLMDMental Health Counselor
MH22438FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jean Gautreaux LLC Mental Health CurrentSince May 1, 2023 Accepting new patients
Baytree Behavioral Health PA CurrentSince May 1, 2024 Accepting new patients
Oasis Therapy and Farm LLC Mental Health CurrentSince Jul 2, 2023 Accepting new patients

Locations

1370 Bedford Dr
Ste 106
Melbourne, FL 32940
Phone (321) 253-8887

4630 Lipscomb St NE
Ste 1A
Palm Bay, FL 32905
Phone (321) 405-2583

Organizations & group practices 3

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1619609435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MOCKINGBIRD AVE SW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329084900",
            "telephone_number": "321-307-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MOCKINGBIRD AVE SW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329084900",
            "telephone_number": "321-307-3363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4630 Lipscomb St NE Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329052940",
            "country_code": "US",
            "telephone_number": "321-405-2583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASZKIEWICZ",
        "first_name": "VANESSA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH20665",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH22438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.