Individual provider Active NPI

Melissa Fulton, LMHC

  • Mental Health Counselor
  • Lakeland, FL
National Provider Identifier
1992165427
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH17828 Issued in FL
Practice address
225 E Lemon St Ste 105
Lakeland, FL 33801-4632
Phone
(239) 690-6906
NPI assigned
Feb 25, 2016
Last updated
May 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 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 MH17828 FL Primary

Addresses

Primary practice location

225 E Lemon St Ste 105
Lakeland, FL 33801-4632

Mailing address

780 Small Oak LN Apt 106
Lakeland, FL 33805-2360
Phone (239) 690-6906

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
I20240108005131 FL Practitioner - Mental Health Counselor 1254782832 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

225 E Lemon St
105 Elite Dna Therapy Services
Lakeland, FL 33801-4627
Phone (239) 223-2751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH17828FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC Mental Health CurrentSince May 13, 2024 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince May 13, 2024 Accepting new patients
Peace River Center for Personal Development Inc CurrentSince Jan 1, 2024 Accepting new patients
Peace River Center for Personal Development Inc PastSince Apr 17, 2022 Accepting new patients

Locations

1239 E Main St
Bartow, FL 33830
Phone (863) 533-8111

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

1825 Gilmore Ave
Lakeland, FL 33805
Phone (863) 248-3300

225 E Lemon St
Ste 105
Lakeland, FL 33801
Phone (863) 732-7200

715 N Lake Ave
Lakeland, FL 33801
Phone (863) 413-2566

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1992165427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 SMALL OAK LN APT 106",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338052360",
            "telephone_number": "239-690-6906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E LEMON ST STE 105",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014632",
            "telephone_number": "239-690-6906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "MELISSA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-25",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.