Circles of Care, Inc.
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Titusville, FL
NPI 1811907322 · NPPES record last updated Apr 16, 2024
Key facts
- NPI
- 1811907322
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- CIRCLES OF CARE, INC.
- Practice address
- 6700 S Washington Ave
Titusville, FL 32780-8050 - Phone
- (321) 269-4590
- Fax
- (321) 268-5689
- NPI assigned
- Aug 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Fallon Derosa, MBA
- Title
- Asst. Director of Human Resources
- Phone
- (321) 722-5273
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 11
Practitioners 6
-
Jessica A Enos, APRN
-
Kelly Fuller, APRN
-
Laila Hansen, PMHNP
-
Khatriena D Johnson, APRN
-
Spencer Kerce, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040528000379 | FL | Part B Supplier - Clinic/Group Practice | 8729069380 |
Receives reassigned benefits from 43 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Melbourne, FL; West Melbourne, FL; Titusville, FL; Rockledge, FL |
National Provider Directory
- Tax ID family
- Circle of Care Inc
Locations
4450 W Eau Gallie Blvd
Melbourne, FL 32934
Phone (321) 255-6627
6700 S Washington Ave
Titusville, FL 32780
Phone (321) 269-4590
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Mental Health Counselor |
101YM0800X | |||
| Psychologist |
103T00000X | |||
| Clinical Social Worker |
1041C0700X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
6700 S Washington Ave
Titusville, FL 32780-8050
Mailing address
400 E Sheridan Rd
Malebourne, FL 32901-3184
Phone (321) 722-5200
Other providers in Titusville, FL
- Amanda Cheshire
- Chiron Urgent Care LLC
- Dennis R Chouinard
- Cynthia Ann Christopher
- Anna Chuyko
- Jasmine Ciru
- City of Titusville
- Clamon Counseling Services
- Sandra Clamon
- Sydney Clark
All providers in Titusville, FL · Mental Health Clinic/Center (Including Community Mental Health Center) in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.