Individual provider Active NPI

Eric Ray Leever, LMHC

  • Mental Health Counselor
  • Port St Lucie, FL
National Provider Identifier
1699962068
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH10303 Issued in FL
Practice address
314 N.W. Bethany Dr
Port St. Lucie, FL 34986
Phone
(772) 284-6030
Fax
(772) 252-5746
NPI assigned
Oct 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 MH10303 FL Primary

Addresses

Primary practice location

314 N.W. Bethany Dr
Port St. Lucie, FL 34986

Mailing address

314 N.W. Bethany Dr
Port St. Lucie, FL 34986
Phone (772) 284-6030

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
I20240319003758 FL Practitioner - Mental Health Counselor 7416294806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Change of Mind LLCGroup PAC ID 4284971672, 6 clinicians

Practice addresses (Care Compare)

314 NW Bethany Dr
Port St Lucie, FL 34986-3578
Phone (772) 284-6030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH10303FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Change of Mind LLC Mental Health CurrentSince Sep 10, 2018 Accepting new patients

Locations

314 NW Bethany Dr
Port St Lucie, FL 34986
Phone (772) 284-6030

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": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699962068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 N.W. BETHANY DR",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "34986",
            "telephone_number": "772-284-6030",
            "fax_number": "772-252-5746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 N.W. BETHANY DR",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "34986",
            "telephone_number": "772-284-6030",
            "fax_number": "772-252-5746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEEVER",
        "first_name": "ERIC",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.