JACK MORTON (NPI# 1588760250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588760250 |
| Entity Type | Individual |
| Full Name | JACK MORTON |
| Credential | LMHC |
| Practice Address |
1800 Penn St Ste 12 Melbourne FL 32901-2625 |
| Mailing Address |
736 Espanola Way Melbourne FL 32901-4140 |
| Practice Telephone | 3217686800 |
| Practice Fax Number | 3217686858 |
| Mailing Telephone | 3217249636 |
| Mailing Fax Number | 6302149175 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH00004351 | FL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | LMHC | MH00004351 | 01 |
| FL | BCBS | Z010Q | 01 |
| Street Address |
1800 PENN ST STE 12 |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-2625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679596084 | Child and Family Consultants, Inc | Speech-Language Pathologist | 1800 Penn St Ste 12, Melbourne, FL 32901-2625 | 2006-07-26 |
| 1790260370 | Heather Disalvo | Occupational Therapy Assistant | 1800 Penn St Ste 12, Melbourne, FL 32901-2625 | 2018-09-28 |
| 1639651508 | Robert Updegrove Counseling Services, Inc. | Counselor | 1800 Penn St Ste 12, Melbourne, FL 32901-2625 | 2018-09-06 |
| 1164901583 | Lauren Nicole Myers | Occupational Therapist | 1800 Penn St Ste 12, Melbourne, FL 32901-2625 | 2018-08-07 |
| 1437661782 | Angela Allen | Occupational Therapy Assistant | 1800 Penn St Ste 12, Melbourne, FL 32901-2625 | 2017-10-26 |
| 1134436884 | Child & Family Consultants, Inc. | Counselor | 1800 Penn St Ste 12, Melbourne, FL 32901-2625 | 2010-09-01 |
| 1205141660 | Elena S Monti | Social Worker | 1800 Penn St Ste 12, Melbourne, FL 32901-2625 | 2010-08-10 |
| 1033449350 | Mary T Williams | Speech-Language Pathologist | 1800 Penn St Ste 12, Melbourne, FL 32901-2625 | 2010-01-08 |
| 1134350457 | Heather M Mommers | Occupational Therapy Assistant | 1800 Penn St Ste 12, Melbourne, FL 32901-2625 | 2009-08-04 |
| 1205067527 | Sarah M Osbourn | Speech-Language Pathologist | 1800 Penn St Ste 12, Melbourne, FL 32901-2625 | 2009-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415944 | Danielle Neal | Counselor | 4173 Palladian Way, Melbourne, FL 32904-1210 | 2020-10-21 |
| 1063022317 | 21 Vets Incorporated | Counselor | 4908 Fauna Dr, Melbourne, FL 32934-7847 | 2020-08-03 |
| 1528689122 | Ichoose Change, LLC | Counselor | 1600 Malabar Rd, J-119, Melbourne, FL 32935-1408 | 2020-05-05 |
| 1588283683 | Benah Counseling LLC | Counselor | 3270 Suntree Blvd Ste 155-157, Melbourne, FL 32940-7530 | 2020-04-09 |
| 1033755376 | Tiffany Brown | Counselor | 8080 Kingswood Way, Melbourne, FL 32940-2191 | 2019-11-21 |
| 1245893403 | Adrianne Vyasulu Leonhardt | Counselor | 3230 Arden Cir, Melbourne, FL 32934-8772 | 2019-04-15 |
| 1801356480 | Neeley Renee Hughey | Counselor | 3270 Suntree Blvd Ste 121, Melbourne, FL 32940-7540 | 2019-03-21 |
| 1487135596 | Dyeanna Fuller | Counselor | 1600 W Eau Gallie Blvd Ste 201f, Melbourne, FL 32935-4149 | 2018-08-27 |
| 1811489925 | Wendy Leonard Hixon | Counselor | 1900 S Harbor City Blvd Ste 211, Melbourne, FL 32901-4760 | 2018-06-04 |
| 1639682297 | Senior Counseling Group, LLC | Counselor | 3270 Suntree Blvd Ste 2217, Melbourne, FL 32940-7558 | 2017-11-06 |
| Find all providers in MELBOURNE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.