Abundant Life Centers LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

ABUNDANT LIFE CENTERS LLC

Practice address

2475 Palm Bay Rd NE Ste 145-23
Palm Bay, FL 32905-3317

Phone

(321) 345-6831

NPI assigned

May 25, 2021

Organization subpart

No

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

Authorized official

Name

Charlene Morris, LMHCNPI 1982184610

Title

Sole Member

Phone

(321) 345-6831

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Charlene W Morris, LMHC

  • Mental Health Counselor
  • Melbourne, FL
  • NPI 1982184610

  FL, Mental Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1003481706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 121196",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329121196",
            "telephone_number": "321-345-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 PALM BAY RD NE STE 145-23",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329053317",
            "telephone_number": "321-345-6831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT LIFE CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "321-345-6831",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Palm Bay, FL
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.