Individual provider · Type 1 NPI

Jack Adam Fasteen

Mental Health Counselor · Melbourne, FL

NPI number 1164338265 Active

Practice location

200 S Harbor City Blvd Ste 401
Melbourne, FL 32901-1389

Call (321) 259-1662 Map

Fax (321) 779-7729

Other practice locations

  • 8249 Devereux Dr Ste 101, Viera, FL 32940-7955 · (321) 259-1662

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X27226 (FL)

Mental Health Counselor: Definition to come...

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About NPI 1164338265

Jack Adam Fasteen's National Provider Identifier is 1164338265, issued on Aug 20, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Melbourne, FL. The record was last updated on Aug 20, 2026.