Katy Ann Redel, LMHC
Individual provider Active NPI Mental Health Counselor · Edgewater, FL
NPI 1689110629 · NPPES record last updated Jun 9, 2022
Key facts
- NPI
- 1689110629
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- MH14686 (FL)
- Practice address
- 2102 S Ridgewood Ave Ste 17
Edgewater, FL 32141-4230 - Phone
- (386) 402-8346
- NPI assigned
- Jan 15, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2111 S Ridgewood Ave
Suite 11
Edgewater, FL 32141-4246
Phone (386) 409-1332
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 |
|---|---|---|---|---|
| I20250922002892 | FL | Practitioner - Mental Health Counselor | 2860997855 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH14686 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Circle of Connections, LLC | Mental Health | Current |
Accepting new patients |
| K Ville LLC | Mental Health | Current | Accepting new patients |
Locations
2111 S Ridgewood Ave
Unit 11
Edgewater, FL 32141
Phone (314) 913-6646
2102 S Ridgewood Ave
Ste 17
Edgewater, FL 32141
Phone (386) 402-8346
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | |||
| Mental Health Counselor | 101YM0800X | MH14686 | FL | Yes |
Addresses
Primary practice location
2102 S Ridgewood Ave Ste 17
Edgewater, FL 32141-4230
Mailing address
2102 S Ridgewood Ave Ste 17
Edgewater, FL 32141-4230
Phone (864) 028-3463
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932862513 | Other | GROUP NPI |
Other providers in Edgewater, FL
- Pulse Medical Staffing LLC
- Nancy Carol Purcell
- Pure Chiropractic & Yoga
- Sandra L Raffety
- Surya Prakash Rao
- Regency Elderly Care, Inc.
- Johnny Rivera-Vargas
- Michelle B Rivera
- Gina Roberson-Johnson
- Tyra Lara Roy
All providers in Edgewater, 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 Jun 9, 2022. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.