Individual provider Active NPI

Krista Marquick

  • Mental Health Counselor
  • Melbourne, FL
National Provider Identifier
1942648407
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH13476 Issued in FL
Practice address
4450 W Eau Gallie Blvd Ste 200
Melbourne, FL 32934-7214
Phone
(321) 726-2860
NPI assigned
Jun 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH13476 FL Primary

Addresses

Primary practice location

4450 W Eau Gallie Blvd Ste 200
Melbourne, FL 32934-7214

Mailing address

400 E Sheridan Rd
Melbourne, FL 32901-3122

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

State licenses

LicenseStateTypeSpecialty
MH13476FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Circles of Care, Inc. Mental Health PastSince Mar 6, 2022 Accepting new patients
Pathways Counseling Center, LLC Mental Health Past Accepting new patients

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": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1942648407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E SHERIDAN RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 W EAU GALLIE BLVD STE 200",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329347214",
            "telephone_number": "321-726-2860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUICK",
        "first_name": "KRISTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-06",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.