Individual provider Active NPI

Michael Rogers, PHD LMHC NCC MCAP

  • Professional Counselor
  • Key West, FL
National Provider Identifier
1760892038
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
MH15691 Issued in FL
Practice address
1111 12TH St Ste 212
Key West, FL 33040-3001
Phone
(305) 783-3677
Fax
(305) 407-3955
NPI assigned
May 7, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Community/Behavioral Health Agency 251S00000X
Professional Counselor 101YP2500X MH15691 FL Primary

Addresses

Primary practice location

1111 12TH St Ste 212
Key West, FL 33040-3001

Mailing address

1111 12TH St Ste 212
Key West, FL 33040-3001
Phone (305) 783-3677

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
I20231116003015 FL Practitioner - Mental Health Counselor 5193002913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Key Bridge IncGroup PAC ID 2769746452, 7 clinicians

Practice addresses (Care Compare)

1111 12TH St
Suite 101
Key West, FL 33040-4084
Phone (305) 783-3677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MH15691FLMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Key Bridge, Inc. Community/Behavioral Health CurrentSince Mar 18, 2018 Accepting new patients
Key Bridge GP Inc PastSince Jan 1, 2024 Accepting new patients

Locations

8650 W Sample Rd
Coral Springs, FL 33065
Phone (305) 783-3677

1111 12th St
Ste 212
Key West, FL 33040
Phone (305) 296-2212

1111 12th St
Ste 101
Key West, FL 33040
Phone (305) 783-3677

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": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1760892038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 12TH ST STE 212",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330403001",
            "telephone_number": "305-783-3677",
            "fax_number": "305-407-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 12TH ST STE 212",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330403001",
            "telephone_number": "305-783-3677",
            "fax_number": "305-407-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "MICHAEL",
        "credential": "PHD LMHC NCC MCAP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-07",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH15691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Key West, FL

Sources for this page

Verify at the official NPI Registry.