Individual provider Active NPI

Michelle Boyles

  • Clinical Social Worker
  • Satellite Beach, FL
National Provider Identifier
1952643801
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW10918 Issued in FL
Practice address
1413 S Patrick Dr
Ste 4
Satellite Beach, FL 32937-4344
Phone
(321) 722-5200
NPI assigned
Mar 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW10918 FL Primary

Addresses

Primary practice location

1413 S Patrick Dr
Ste 4
Satellite Beach, FL 32937-4344

Mailing address

1413 S Patrick Dr
Ste 4
Satellite Beach, FL 32937-4344

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
I20140902000485 FL Practitioner - Clinical Social Worker 2961620182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1413 S Patrick Dr
Satellite Beach, FL 32937-4344
Phone (772) 494-1215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW10918FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Monarch Counseling LLC Clinical CurrentSince Mar 15, 2021 Accepting new patients

Locations

1413 South Patrick Dr
Ste 4
Satellite Beach, FL 32937
Phone (321) 960-6959

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": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1952643801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 S PATRICK DR",
            "address_2": "STE 4",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329374344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 S PATRICK DR",
            "address_2": "STE 4",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329374344",
            "telephone_number": "321-722-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLES",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-19",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Satellite Beach, FL

Sources for this page

Verify at the official NPI Registry.