Individual provider Active NPI

Nicole J Sharbono, L.M.H.C, CAP

  • Mental Health Counselor
  • Daytona Beach, FL
National Provider Identifier
1730481656
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH10542 Issued in FL
Practice address
1220 Willis Ave
Daytona Beach, FL 32114-2810
Phone
(407) 474-9510
NPI assigned
Nov 29, 2010
Last updated
Sep 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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 MH10542 FL Primary

Addresses

Primary practice location

1220 Willis Ave
Daytona Beach, FL 32114-2810

Mailing address

150 Magnolia Ave
Daytona Beach, FL 32114-4304
Phone (407) 474-9510

Other identifiers 2

IdentifierTypeStateIssuer
009498700MedicaidFL
MH10542OtherFLLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH10542FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sma Healthcare Inc PastSince Jul 28, 2019 Accepting new patients
Sma Healthcare Inc Past Accepting new patients
Sma Healthcare Inc Past Accepting new patients

Organizations & group practices 3

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": "1290988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1730481656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MAGNOLIA AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144304",
            "telephone_number": "407-474-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 WILLIS AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142810",
            "telephone_number": "407-474-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARBONO",
        "first_name": "NICOLE",
        "middle_name": "J",
        "credential": "L.M.H.C, CAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-29",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009498700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MH10542",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.