Individual provider Active NPI

Heather Joyce Payne, MA MHC

  • Mental Health Counselor
  • Tavares, FL
National Provider Identifier
1699062778
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH9062 Issued in FL
Practice address
5596 Gulf Stream St
Tavares, FL 32778-9238
Phone
(239) 810-9011
NPI assigned
Jul 8, 2011
Last updated
Feb 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 12301 FL
Mental Health Counselor 101YM0800X IMH9062 FL Primary

Addresses

Primary practice location

5596 Gulf Stream St
Tavares, FL 32778-9238

Mailing address

5596 Gulf Stream St
Tavares, FL 32778-9238
Phone (239) 810-9011

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
I20231130000751 FL Practitioner - Mental Health Counselor 1052769155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thriveworks Clinical - Florida IncGroup PAC ID 5496173577, 85 clinicians

Practice addresses (Care Compare)

1601 Belvedere Rd
Suite S 204
West Palm Beach, FL 33406-1541
Phone (561) 536-5293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
12301FLMDMental Health Counselor
IMH9062FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - Florida Inc Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

2425 E Commercial Blvd
Ste 405
Fort Lauderdale, FL 33308
Phone (754) 400-5514

4115 W Spruce St
Ste 205
Tampa, FL 33607
Phone (813) 413-4663

1601 Belvedere Rd
Ste S204
West Palm Beach, FL 33406
Phone (561) 536-5293

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1699062778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5596 GULF STREAM ST",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327789238",
            "telephone_number": "239-810-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5596 GULF STREAM ST",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327789238",
            "telephone_number": "239-810-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "HEATHER",
        "middle_name": "JOYCE",
        "name_prefix": "Mrs.",
        "credential": "MA MHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "12301",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH9062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.