Individual provider Active NPI

Alexa Paige Puccio Ball, LMHC

  • Mental Health Counselor
  • Winter Park, FL
National Provider Identifier
1619794286
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH24358 Issued in FL
Practice address
1801 Lee Rd Ste 165
Winter Park, FL 32789-2127
Phone
(407) 821-3547
NPI assigned
Sep 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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 MH24358 FL Primary

Addresses

Primary practice location

1801 Lee Rd Ste 165
Winter Park, FL 32789-2127

Mailing address

1801 Lee Rd Ste 165
Winter Park, FL 32789-2127
Phone (407) 821-3547

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
I20250107003750 FL Practitioner - Mental Health Counselor 2769910579 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Dec 30, 2024 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Dec 30, 2024 Accepting new patients

Locations

410 Waymont Ct
Lake Mary, FL 32746
Phone (407) 323-3550

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1801 Lee Rd
Ste 165
Winter Park, FL 32789
Phone (407) 975-0406

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": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1619794286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 LEE RD STE 165",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892127",
            "telephone_number": "407-821-3547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 LEE RD STE 165",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892127",
            "telephone_number": "407-821-3547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCCIO BALL",
        "first_name": "ALEXA",
        "middle_name": "PAIGE",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-24",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH24358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.