Individual provider Active NPI

Shelly A Mentus, LMHC, MCAP

  • Professional Counselor
  • Riverview, FL
National Provider Identifier
1942738513
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
MH23899 Issued in FL
Practice address
10428 Yellow Spice CT
Riverview, FL 33578-3410
Phone
(813) 830-8055
Fax
(813) 319-5447
NPI assigned
May 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X MH23899 FL Primary

Addresses

Primary practice location

10428 Yellow Spice CT
Riverview, FL 33578-3410

Mailing address

10428 Yellow Spice CT
Riverview, FL 33578-3410
Phone (718) 662-6473

Other identifiers 2

IdentifierTypeStateIssuer
015558700MedicaidFL
MH23899OtherFLIRS

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rei of Light Counseling, PLLC Professional CurrentSince Jul 21, 2024 Accepting new patients

Organizations & group practices 1

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": "1495756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1942738513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10428 YELLOW SPICE CT",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335783410",
            "telephone_number": "718-662-6473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10428 YELLOW SPICE CT",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335783410",
            "telephone_number": "813-830-8055",
            "fax_number": "813-319-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENTUS",
        "first_name": "SHELLY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LMHC, MCAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-26",
        "last_updated": "2024-06-26",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH23899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015558700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "MH23899",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

Verify at the official NPI Registry.