NPIMap

Organization Active NPI

E5 Therapy Inc.

  • Mental Health Counselor
  • Tampa, FL
National Provider Identifier
1083390124
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
E5 THERAPY INC.
Practice address
410 S Ware Blvd Ste 844
Tampa, FL 33619-4469
Phone
(813) 362-6788
Fax
(813) 803-7348
NPI assigned
Jun 23, 2023
Organization subpart
Yes
Parent organization
E5 THERAPYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Authorized official

Name
Matthew Eilers DeckerNPI 1386965069
Title
Executive Director/Board President
Phone
(602) 363-3156

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
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

410 S Ware Blvd Ste 844
Tampa, FL 33619-4469

Mailing address

333 Sunset Ave Ste 200
Suisun City, CA 94585-2003
Phone (707) 225-7899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240328000382 FL Part B Supplier - Clinic/Group Practice 8527478627 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory
Part of
E5 Therapy Inc

Locations

333 Sunset Ave
Ste 200
Suisun City, CA 94585
Phone (707) 225-7899

410 S Ware Blvd
Ste 800
Tampa, FL 33619

410 S Ware Blvd
Ste 844
Tampa, FL 33619
Phone (707) 225-7899

Practitioners & affiliated clinicians

Practitioners 11

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": "1687478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1083390124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SUNSET AVE STE 200",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945852003",
            "telephone_number": "707-225-7899",
            "fax_number": "707-759-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S WARE BLVD STE 844",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194469",
            "telephone_number": "813-362-6788",
            "fax_number": "813-803-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E5 THERAPY INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "E5 THERAPY",
        "enumeration_date": "2023-06-23",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "EILERS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/BOARD PRESIDENT",
        "authorized_official_telephone_number": "602-363-3156"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.

Verify at the official NPI Registry.