Individual provider Active NPI

Debra Sue Connors, LMHC

  • Mental Health Counselor
  • Tallahassee, FL
National Provider Identifier
1104416080
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH14408 Issued in FL
Practice address
2634 Capital Cir NE
Tallahassee, FL 32308-4106
Phone
(850) 363-0906
NPI assigned
Jan 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH14408 FL Primary

Addresses

Primary practice location

2634 Capital Cir NE
Tallahassee, FL 32308-4106

Mailing address

10418 Merribrooke LN
Tallahassee, FL 32312-5215
Phone (848) 459-2057

Other practice location 1

225 SW Sumatra Ave
Madison, FL 32340-1454
Phone (850) 363-0906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH14408FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1104416080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10418 MERRIBROOKE LN",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323125215",
            "telephone_number": "848-459-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2634 CAPITAL CIR NE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084106",
            "telephone_number": "850-363-0906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 SW Sumatra Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "FL",
            "postal_code": "323401454",
            "country_code": "US",
            "telephone_number": "850-363-0906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNORS",
        "first_name": "DEBRA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH14408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.