NPIMap

Organization Active NPI

Private Practice Counseling Inc

  • Community/Behavioral Health Agency
  • Orlando, FL
National Provider Identifier
1063939163
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MH16047 Issued in FL
Legal business name
PRIVATE PRACTICE COUNSELING INC
Practice address
1613 Gattis Dr
Orlando, FL 32825
Phone
(773) 218-9651
NPI assigned
Aug 29, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Jorge M Santaella, LMHCNPI 1982044590
Title
Licensed Mental Health Counsel
Phone
(773) 218-9651

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)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MH16047 FL Primary

Addresses

Primary practice location

1613 Gattis Dr
Orlando, FL 32825

Mailing address

1613 Gattis Dr
Orlando, FL 32825-5409
Phone (312) 450-4444

Other practice location 1

611 W Briar Pl
Unit 7
Chicago, IL 60657
Phone (312) 450-4444

Other identifiers 1

IdentifierTypeStateIssuer
MH16047OtherFLPRIVATE HEALTH INSURANCE PROVIDERS

Other names 1

  • Private Practice Counseling Inc Former legal business name

National Provider Directory

National Provider Directory

Locations

611 W Briar Pl
Ste 7
Chicago, IL 60657
Phone (312) 450-4444

Practitioners & 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.

NPI Registry JSON

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1063939163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 GATTIS DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328255409",
            "telephone_number": "312-450-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 GATTIS DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32825",
            "telephone_number": "773-218-9651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 W Briar Pl",
            "address_2": "Unit 7",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60657",
            "country_code": "US",
            "telephone_number": "312-450-4444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIVATE PRACTICE COUNSELING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SANTAELLA",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LICENSED MENTAL HEALTH COUNSEL",
        "authorized_official_telephone_number": "773-218-9651",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "MH16047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTH INSURANCE PROVIDERS",
            "identifier": "MH16047",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Private Practice Counseling Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Private Practice Counseling Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.