Individual provider Active NPI

Abisha Merin John, M.S.

  • Mental Health Counselor
  • Maitland, FL
National Provider Identifier
1760895080
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
013164 Issued in NY
Practice address
225 S Swoope Ave
Maitland, FL 32751-5704
Phone
(954) 682-2275
NPI assigned
Jun 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH20326 FL
Mental Health Counselor 101YM0800X 013164 NY Primary

Addresses

Primary practice location

225 S Swoope Ave
Maitland, FL 32751-5704

Mailing address

PO Box 677524
Orlando, FL 32867-7524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20240323000291 FL Practitioner - Mental Health Counselor 8224475413 Reassigns benefits to 1 organization
I20240329001433 NY Practitioner - Mental Health Counselor 8224475413 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Valera Medical, P.C. Counselor CurrentSince Feb 18, 2024 Accepting new patients
Valera Medical, P.a. Mental Health CurrentSince Mar 1, 2024 Accepting new patients

Locations

1800 Pembrook Dr
Ste 300
Orlando, FL 32810
Phone (321) 200-4489

134 N 4th St
Brooklyn, NY 11249

139 Centre St
Ste 824
New York, NY 10013
Phone (646) 450-7751

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": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1760895080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 677524",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328677524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S SWOOPE AVE",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515704",
            "telephone_number": "954-682-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "ABISHA",
        "middle_name": "MERIN",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-04",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH20326",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "013164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.