Heather Brinker

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

260 Paseo Reyes Dr
St Augustine, FL 32095-8462

Phone

(904) 710-2092

NPI assigned

Apr 5, 2023

Last updated

Apr 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 18, 2025 through Feb 18, 2027

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Roots of Discovery LLC

  dba Roots of Discovery Counseling

  • Mental Health Counselor
  • St Augustine, FL
  • NPI 1811704760
  NPD Authorized official

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1801581988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 TARPON BAY CT",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320811501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 PASEO REYES DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958462",
            "telephone_number": "904-710-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKER",
        "first_name": "HEATHER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Brewton, OTR/L
• Lisa M Brice, LCSW
• Bridge to Shore Recovery, LLC (The Augustine Recovery Center)
• Bridge to Shore Recovery, LLC (The Augustine Recovery Center)
• Brightside Pediatrics
• Lisa Britt, LMHC
• Lisa Kay Britton-Willette, RN
• Betsy Britton, MA,CCC
• Michele Brockway, MS, OTR/L
• Todd Broder, M.D.

• Mental Health Counselor in St Augustine, FL
• Providers in St Augustine, 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 Apr 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.