MEDICARE: JADE MENTAL HEALTH AND WELLNESS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1356275648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JADE MENTAL HEALTH AND WELLNESS, PLLC

Provider Business Mailing Address
First Line	:	511 DELANNOY AVE STE 2
Second Line	:
City	:	COCOA
State	:	FL
Zip	:	32922-8202
Country	:	US
Telephone Number	:	321-495-7140
Fax Number	:

Provider Business Practice Location Address
First Line	:	511 DELANNOY AVE STE 2
Second Line	:
City	:	COCOA
State	:	FL
Zip	:	32922-8202
Country	:	US
Telephone Number	:	321-495-7140
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KELSEY LYNN BAUER WEBB
Credential	:	APRN, PMHNP-BC
Telephone Number	:	321-505-7555

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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