Individual provider Active NPI

Breanna Renee Knuth, LMHC

  • Mental Health Counselor
  • Bradenton, FL
National Provider Identifier
1992060685
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH12871 Issued in FL
Practice address
9030 58TH Dr E Ste 103
Bradenton, FL 34202-6108
Phone
(941) 567-6207
NPI assigned
Jul 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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 MH12871 FL Primary

Addresses

Primary practice location

9030 58TH Dr E Ste 103
Bradenton, FL 34202-6108

Mailing address

9030 58TH Dr E Ste 103
Bradenton, FL 34202-6108
Phone (941) 567-6207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 13, 2025 through Jan 13, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH12871FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Envision Counseling Services Mental Health PastSince Jan 26, 2022 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": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1992060685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9030 58TH DR E STE 103",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342026108",
            "telephone_number": "941-567-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9030 58TH DR E STE 103",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342026108",
            "telephone_number": "941-567-6207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTH",
        "first_name": "BREANNA",
        "middle_name": "RENEE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.