Individual provider Active NPI

Monica Jean Amelunge, PSR

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Palm Bay, FL
National Provider Identifier
1902322654
Registry record updated Aug 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Practice address
1071 Port Malabar Blvd NE Ste 106
Palm Bay, FL 32905-5161
Phone
(407) 720-8887
NPI assigned
Aug 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1071 Port Malabar Blvd NE Ste 106
Palm Bay, FL 32905-5161

Mailing address

726 Madelyn Way Apt 207
Melbourne, FL 32901-3282
Phone (407) 448-0776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502755200000",
    "number": "1902322654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 MADELYN WAY APT 207",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013282",
            "telephone_number": "407-448-0776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 PORT MALABAR BLVD NE STE 106",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329055161",
            "telephone_number": "407-720-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMELUNGE",
        "first_name": "MONICA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "PSR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2017-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.