Phyllis McColister-Cunningham, M.S., LMHC, CAP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH14456 Issued in FL

Practice address

900 Virginia Ave Ste 7
Fort Pierce, FL 34982-5882

Phone

(772) 448-4189

Fax

(772) 245-4259

NPI assigned

Aug 10, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, GA, MA3 enrollments

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 3

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  GA, MA

  Medicare reassignment Care Compare group NPD
• Phyllis McColister-Cunningham PA

  • Community/Behavioral Health Agency
  • Fort Pierce, FL
  • NPI 1245766807
  NPD Authorized official
• Phyllis McColister-Cunningham PA

  dba Healing Waters Counseling

  • Mental Health Counselor
  • Fort Pierce, FL
  • NPI 1912611260
  NPD Authorized official

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

{
    "created_epoch": "1407628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1760891121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 VIRGINIA AVE STE 7",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349825882",
            "telephone_number": "772-448-4189",
            "fax_number": "772-245-4259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 VIRGINIA AVE STE 7",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349825882",
            "telephone_number": "772-448-4189",
            "fax_number": "772-245-4259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLISTER-CUNNINGHAM",
        "first_name": "PHYLLIS",
        "name_prefix": "Mrs.",
        "credential": "M.S., LMHC, CAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-10",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "650789152",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH14456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUNCOAST",
            "identifier": "650789152",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jennifer M. McDaniel, M.A., CCC-SLP
• Deborah Ann McGee, RN
• Greg McGee

• Mental Health Counselor in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.