NPIMap

Organization Active NPI

Family & Child Development of Northwest Florida, Inc.

  • Marriage & Family Therapist
  • Fort Walton Beach, FL
National Provider Identifier
1093129017
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT1326 Issued in FL
Legal business name
FAMILY & CHILD DEVELOPMENT OF NORTHWEST FLORIDA, INC.
Practice address
348 Miracle Strip Pkwy SW
Suite B-3
Fort Walton Beach, FL 32548-5200
Phone
(850) 862-3772
Fax
(850) 863-4574
NPI assigned
Jun 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Authorized official

Name
Dr. Elizabeth Glyn Brown, PH.D.NPI 1831263037
Title
Owner
Phone
(850) 862-3772

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
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X MT1326 FL Primary

Addresses

Primary practice location

348 Miracle Strip Pkwy SW
Suite B-3
Fort Walton Beach, FL 32548-5200

Mailing address

348 Miracle Strip Pkwy SW
Suite B-3
Fort Walton Beach, FL 32548-5200
Phone (850) 862-3772

National Provider Directory

National Provider Directory
Tax ID family
Family and Child Development2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

348 Miracle Strip Pkwy SW
Ste 3B
Fort Walton Beach, FL 32548
Phone (850) 862-3772

Practitioners & affiliated clinicians

Practitioners 12

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": "1403049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403049600000",
    "number": "1093129017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 MIRACLE STRIP PKWY SW",
            "address_2": "SUITE B-3",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485200",
            "telephone_number": "850-862-3772",
            "fax_number": "850-863-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 MIRACLE STRIP PKWY SW",
            "address_2": "SUITE B-3",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485200",
            "telephone_number": "850-862-3772",
            "fax_number": "850-863-4574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY & CHILD DEVELOPMENT OF NORTHWEST FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-18",
        "last_updated": "2014-06-18",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "GLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-862-3772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT1326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; 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.