Samyra Addison Boney
Individual provider Active NPI Mental Health Counselor · Clermont, FL
NPI 1669509121 · NPPES record last updated Sep 20, 2024
Key facts
- NPI
- 1669509121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 715 Almond St
Clermont, FL 34711-3121 - Phone
- (352) 241-4187
- Fax
- (352) 241-4684
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240802003075 | FL | Practitioner - Mental Health Counselor | 1658818075 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| People Matter Counseling Resource Center | Mental Health | Current | Accepting new patients |
| Aspire Health Partners, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
715 Almond St
Clermont, FL 34711-3121
Mailing address
715 Almond St Ste a
Clermont, FL 34711-3121
Phone (352) 241-4187
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 756701400 | Medicaid | FL | |
| 003054400 | Medicaid | FL |
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All providers in Clermont, FL · Mental Health Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.