Counseling Associates of Port Orange, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

SW3855 Issued in FL

Legal business name

COUNSELING ASSOCIATES OF PORT ORANGE, INC.

Practice address

3959 S Nova Rd
Suite 5
Port Orange, FL 32127-9278

Phone

(386) 761-2390

Fax

(386) 761-3256

NPI assigned

Dec 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Patti K Hall, PHD

Title

Secretary/Treasurer

Phone

(386) 761-2390

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Clark Pennell, PHD

  • Psychologist
  • Port Orange, FL
  • NPI 1538102959
  NPD (past)

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1003099516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 S NOVA RD",
            "address_2": "SUITE 5",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279278",
            "telephone_number": "386-761-2390",
            "fax_number": "386-761-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 S NOVA RD",
            "address_2": "SUITE 5",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279278",
            "telephone_number": "386-761-2390",
            "fax_number": "386-761-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING ASSOCIATES OF PORT ORANGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "PATTI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "386-761-2390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW3855",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "SW3855",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "X1496",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James W Corwin, PT
• Sara Rebecca Corwin, FNP-C
• Caitlin Costello
• Joseph Couche
• Counseling & Consultation, Corp.
• Country Manor Assisted Living & Retirement Home, LLC
• Sharyn Coville
• Rebecca Cowden
• Caitlyn Coyne, BCABA
• Sean Douglas Crafton, DC

• Mental Health Counselor in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.