NPIMap

Organization Active NPI

Life Counseling Professional Services

  • Mental Illness Community Based Residential Treatment Facility
  • Brandon, FL
National Provider Identifier
1073809901
Registry record updated Jun 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
LIFE COUNSELING PROFESSIONAL SERVICES
Practice address
403 Lithia Pinecrest Rd
Brandon, FL 33511-6138
Phone
(800) 990-0340
NPI assigned
Jun 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2011

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

Authorized official

Name
Deja Gilbert
Title
Ceo
Phone
(800) 990-0340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

403 Lithia Pinecrest Rd
Brandon, FL 33511-6138

Mailing address

2260 Palm Beach Lakes Blvd
Suite 212
West Palm Beach, FL 33409-3411
Phone (800) 990-0340

National Provider Directory

National Provider Directory
Tax ID family
Life Counseling Professional Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308528000000",
    "number": "1073809901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 PALM BEACH LAKES BLVD",
            "address_2": "SUITE 212",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334093411",
            "telephone_number": "800-990-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 LITHIA PINECREST RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116138",
            "telephone_number": "800-990-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE COUNSELING PROFESSIONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-20",
        "last_updated": "2011-06-20",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "DEJA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "800-990-0340"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; 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.