Individual provider Active NPI

Amy Rose Hertzberg-Meade, LMHC

  • Mental Health Counselor
  • Brandon, FL
National Provider Identifier
1689431298
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH23171 Issued in FL
Practice address
1423 Oakfield Dr
Brandon, FL 33511-2801
Phone
(813) 753-0866
NPI assigned
Feb 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 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 MH23171 FL Primary

Addresses

Primary practice location

1423 Oakfield Dr
Brandon, FL 33511-2801

Mailing address

1014 Kay Jean Dr
Valrico, FL 33594-4628
Phone (813) 597-9309

Other identifiers 1

IdentifierTypeStateIssuer
1689320756OtherMENTAL HEALTH

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
I20240418000782 FL Practitioner - Mental Health Counselor 9234578626 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Learning to Achieve Wellness IncGroup PAC ID 9234514464, 48 clinicians

Practice addresses (Care Compare)

413 W Robertson St
Suite B
Brandon, FL 33511-5014
Phone (813) 999-1516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince May 20, 2024 Accepting new patients
Learning to Achieve Wellness Inc CurrentSince Apr 7, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

615 Oakfield Dr
Brandon, FL 33511
Phone (813) 565-3322

413 W Robertson St
Ste B
Brandon, FL 33511
Phone (813) 657-4711

16332 Cortez Blvd
Ste F
Brooksville, FL 34601

260 Lookout Pl
Ste 202
Maitland, FL 32751
Phone (407) 537-9450

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": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1689431298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 KAY JEAN DR",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335944628",
            "telephone_number": "813-597-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335112801",
            "telephone_number": "813-753-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTZBERG-MEADE",
        "first_name": "AMY",
        "middle_name": "ROSE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH23171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH",
            "identifier": "1689320756",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.