Individual provider Active NPI

Katie Palmquist, M.A.

  • Mental Health Counselor
  • Longwood, FL
National Provider Identifier
1952767642
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH15981 Issued in FL
Practice address
2290 N Ronald Reagan Blvd Ste 116
Longwood, FL 32750-3534
Phone
(407) 215-0095
Fax
(407) 659-0411
NPI assigned
Jan 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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 MH15981 FL Primary

Addresses

Primary practice location

2290 N Ronald Reagan Blvd Ste 116
Longwood, FL 32750-3534

Mailing address

2290 N Ronald Reagan Blvd Ste 116
Longwood, FL 32750-3534
Phone (407) 215-0095

Other identifiers 1

IdentifierTypeStateIssuer
025125300MedicaidFL

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
I20231208000033 FL Practitioner - Mental Health Counselor 2365891991 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MH15981FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Impower, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

2290 N Ronald Reagan Blvd
Ste 116
Longwood, FL 32750
Phone (407) 215-0095

111 W Magnolia Ave
Longwood, FL 32750
Phone (407) 215-0095

580 Old Sanford Oviedo Rd
Winter Springs, FL 32708
Phone (407) 215-0095

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": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1952767642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 N RONALD REAGAN BLVD STE 116",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503534",
            "telephone_number": "407-215-0095",
            "fax_number": "407-659-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 N RONALD REAGAN BLVD STE 116",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503534",
            "telephone_number": "407-215-0095",
            "fax_number": "407-659-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMQUIST",
        "first_name": "KATIE",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH15981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025125300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.