Individual provider Active NPI

Kristie Cooley, LMHC

  • Mental Health Counselor
  • Orlando, FL
National Provider Identifier
1619781507
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH25014 Issued in FL
Practice address
10967 Lake Underhill Rd Ste 113
Orlando, FL 32825-4434
Phone
(833) 769-3524
Fax
(407) 412-9170
NPI assigned
Feb 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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 MH25014 FL Primary

Addresses

Primary practice location

10967 Lake Underhill Rd Ste 113
Orlando, FL 32825-4434

Mailing address

10967 Lake Underhill Rd Ste 113
Orlando, FL 32825-4434
Phone (833) 769-3524

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
I20250520004186 FL Practitioner - Mental Health Counselor 3375061591 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suncoast Psychotherapy LLCGroup PAC ID 5698117182, 3 clinicians

Practice addresses (Care Compare)

7673 Ridgelake Cir
Bradenton, FL 34203-2508
Phone (941) 900-8661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH25014FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Psychotherapy LLC CurrentSince May 1, 2025 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Aug 15, 2025 Accepting new patients
Personal Recovery Network LLC CurrentSince Mar 16, 2026 Accepting new patients

Locations

1530 Celebration Blvd
Ste 405
Kissimmee, FL 34747
Phone (321) 559-7015

260 Lookout Pl
Ste 202
Maitland, FL 32751
Phone (407) 537-9450

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

10967 Lake Underhill Rd
Ste 113
Orlando, FL 32825
Phone (407) 537-9451

Organizations & group practices 4

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": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1619781507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10967 LAKE UNDERHILL RD STE 113",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254434",
            "telephone_number": "833-769-3524",
            "fax_number": "407-412-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10967 LAKE UNDERHILL RD STE 113",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254434",
            "telephone_number": "833-769-3524",
            "fax_number": "407-412-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "KRISTIE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH25014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.