Active NPI
Laura Hall Willis, LMHC
- Mental Health Counselor
- Vero Beach, FL
National Provider Identifier
1639234560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH-OOO4171
- Practice address
- 1405 21St St
Vero Beach, FL 32960-3490 - Phone
- (772) 567-6370
- Fax
- (772) 567-2672
- NPI assigned
- Dec 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH-OOO4171 | FL | Primary |
Addresses
Primary practice location
1405 21St St
Vero Beach, FL 32960-3490
Mailing address
PO Box 92
Vero Beach, FL 32961-0092
Phone (772) 567-6370
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260126001210 | FL | Practitioner - Mental Health Counselor | 5193202760 | Practice locations: Vero Beach, FL |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2080 15TH Ave
Vero Beach, FL 32960-3403
Phone (772) 567-6370
PO Box
Suite 92
Vero Beach, FL 32961
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH-OOO4171 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639234560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 92",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329610092",
"telephone_number": "772-567-6370",
"fax_number": "772-567-3307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 21ST ST",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329603490",
"telephone_number": "772-567-6370",
"fax_number": "772-567-2672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "LAURA",
"middle_name": "HALL",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH-OOO4171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vero Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.