NPIMap

Organization Active NPI

Healing Panda Boca Raton LLC

  • Mental Health Counselor
  • Boca Raton, FL
National Provider Identifier
1053020271
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
HEALING PANDA BOCA RATON LLC
Practice address
2201 NW Corporate Blvd Ste 101
Boca Raton, FL 33431-7337
Phone
(561) 617-8751
Fax
(561) 423-0711
NPI assigned
Nov 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
David Rojas
Title
Owner
Phone
(305) 746-4573

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

2201 NW Corporate Blvd Ste 101
Boca Raton, FL 33431-7337

Mailing address

2201 NW Corporate Blvd Ste 101
Boca Raton, FL 33431-7337
Phone (561) 617-8751

Other names 1

  • Ellie Mental Health Boca Raton Doing business as

National Provider Directory

National Provider Directory

Locations

2201 NW Corporate Blvd
Ste 101
Boca Raton, FL 33431
Phone (561) 617-8751

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1053020271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 NW CORPORATE BLVD STE 101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317337",
            "telephone_number": "561-617-8751",
            "fax_number": "561-423-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 NW CORPORATE BLVD STE 101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317337",
            "telephone_number": "561-617-8751",
            "fax_number": "561-423-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING PANDA BOCA RATON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-16",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "ROJAS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-746-4573"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellie Mental Health Boca Raton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ellie Mental Health Boca Raton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.