Individual provider Active NPI

Kenneth Michael Nutter, PHD, LMHC

  • Professional Counselor
  • Venice, FL
National Provider Identifier
1043383235
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
MH 5058 Issued in FL
Practice address
230 Tamiami TRL S
Suite 3
Venice, FL 34285-2453
Phone
(941) 375-5222
Fax
(941) 460-5109
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X MH 5058 FL Primary

Addresses

Primary practice location

230 Tamiami TRL S
Suite 3
Venice, FL 34285-2453

Mailing address

516 Center Rd
Venice, FL 34285-4803
Phone (941) 375-5222

Other identifiers 1

IdentifierTypeStateIssuer
767676000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MH 5058FLMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Counseling Associates LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1043383235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 CENTER RD",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342854803",
            "telephone_number": "941-375-5222",
            "fax_number": "941-460-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 TAMIAMI TRL S",
            "address_2": "SUITE 3",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852453",
            "telephone_number": "941-375-5222",
            "fax_number": "941-460-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTTER",
        "first_name": "KENNETH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHD, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH 5058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767676000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; 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.