Individual provider Active NPI

Debra Marie Pelosi

  • Mental Health Counselor
  • Newberry, FL
National Provider Identifier
1689401549
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH11003 Issued in FL
Practice address
810 NW 125TH Dr
Newberry, FL 32669-2718
Phone
(352) 332-1330
NPI assigned
Sep 16, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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 MH11003 FL Primary

Addresses

Primary practice location

810 NW 125TH Dr
Newberry, FL 32669-2718

Mailing address

810 NW 125TH Dr
Newberry, FL 32669-2718
Phone (352) 332-1330

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
I20250114000260 FL Practitioner - Mental Health Counselor 1850829268 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Assessment and Counseling Inc Mental Health CurrentSince Sep 23, 2024 Accepting new patients

Organizations & group practices 1

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": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1689401549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 NW 125TH DR",
            "city": "NEWBERRY",
            "state": "FL",
            "postal_code": "326692718",
            "telephone_number": "352-332-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 NW 125TH DR",
            "city": "NEWBERRY",
            "state": "FL",
            "postal_code": "326692718",
            "telephone_number": "352-332-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELOSI",
        "first_name": "DEBRA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberry, FL

Sources for this page

Verify at the official NPI Registry.