Individual provider Active NPI

Shaunese A Dumas, LMHC

  • Mental Health Counselor
  • Winter Haven, FL
National Provider Identifier
1720456155
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH 13706 Issued in FL
Practice address
1201 1St St S
Winter Haven, FL 33880-3904
Phone
(407) 603-1306
NPI assigned
Sep 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 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 IMH 13706 FL Primary

Addresses

Primary practice location

1201 1St St S
Winter Haven, FL 33880-3904

Mailing address

1201 1St St S
Winter Haven, FL 33880-3904
Phone (863) 294-7062

Other names 1

  • Shaunese A Foreman Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Shaunese.Dumas@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

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
I20231122001759 FL Practitioner - Mental Health Counselor 1658729108 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IMH 13706FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Winter Haven Hospital Inc CurrentSince Jan 1, 2024 Accepting new patients
Sondermind Provider Network LLC CurrentSince Feb 1, 2026 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2995 Drew St
Bldg 2ND
Clearwater, FL 33759

333 SE 2nd Ave
Ste 2000
Miami, FL 33131
Phone (201) 581-3411

1201 1st St S
Winter Haven, FL 33880
Phone (863) 294-7062

Interoperability endpoints

  • Direct secure messaging: shaunese.dumas@direct.mybaycare.org

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": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1720456155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 1ST ST S",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803904",
            "telephone_number": "863-294-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 1ST ST S",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803904",
            "telephone_number": "407-603-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMAS",
        "first_name": "SHAUNESE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH 13706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Shaunese.Dumas@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew Street",
            "address_2": "East Bldg 2nd Floor",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHAUNESE",
            "last_name": "FOREMAN",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.