Active NPI
Integrated Health Clinical Counseling P.L.L.C.
- Mental Health Counselor
- Ponte Vedra, FL
National Provider Identifier
1053833566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- INTEGRATED HEALTH CLINICAL COUNSELING P.L.L.C.
- Practice address
- 90 Fort Wade Rd Ste 100
Ponte Vedra, FL 32081-5114 - Phone
- (734) 720-9782
- Fax
- (734) 571-6888
- NPI assigned
- Jul 17, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Karl Kunzi
- Title
- Owner
- Phone
- (734) 720-9782
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
90 Fort Wade Rd Ste 100
Ponte Vedra, FL 32081-5114
Mailing address
90 Fort Wade Rd Ste 100
Ponte Vedra, FL 32081-5114
Phone (734) 787-2183
Other practice location 1
2955 Biddle Ave
Wyandotte, MI 48192-5231
Phone (734) 720-9782
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Mental Health Counselor
- Ponte Vedra, FL
- NPI 1215284229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500249600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1721001600000",
"number": "1053833566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 FORT WADE RD STE 100",
"city": "PONTE VEDRA",
"state": "FL",
"postal_code": "320815114",
"telephone_number": "734-787-2183",
"fax_number": "734-571-6888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 FORT WADE RD STE 100",
"city": "PONTE VEDRA",
"state": "FL",
"postal_code": "320815114",
"telephone_number": "734-720-9782",
"fax_number": "734-571-6888"
}
],
"practiceLocations": [
{
"address_1": "2955 Biddle Ave",
"address_purpose": "LOCATION",
"city": "Wyandotte",
"state": "MI",
"postal_code": "481925231",
"country_code": "US",
"telephone_number": "734-720-9782",
"fax_number": "734-571-6888",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "INTEGRATED HEALTH CLINICAL COUNSELING P.L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2017-07-17",
"last_updated": "2024-07-15",
"certification_date": "2024-07-15",
"status": "A",
"authorized_official_last_name": "KUNZI",
"authorized_official_first_name": "KARL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "734-720-9782"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ponte Vedra, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.