Individual provider Active NPI

Jessica Barreto

  • Mental Health Counselor
  • Fort Myers, FL
National Provider Identifier
1851060370
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
11932 Fairway Lakes Dr
Fort Myers, FL 33913-8337
Phone
(239) 237-2801
NPI assigned
Sep 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

11932 Fairway Lakes Dr
Fort Myers, FL 33913-8337

Mailing address

11932 Fairway Lakes Dr
Fort Myers, FL 33913-8337
Phone (239) 237-2801

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
I20240311001548 FL Practitioner - Mental Health Counselor 2466898663 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Feb 1, 2024 Accepting new patients
Chrysallis Wellness Center Inc Mental Health CurrentSince Sep 12, 2021 Accepting new patients
Chrysallis Wellness Center Mental Health CurrentSince Jun 11, 2023 Accepting new patients

Locations

11932 Fairway Lakes Dr
Fort Myers, FL 33913
Phone (239) 237-2801

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24796/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1851060370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11932 FAIRWAY LAKES DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138337",
            "telephone_number": "239-237-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11932 FAIRWAY LAKES DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138337",
            "telephone_number": "239-237-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRETO",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.