Exchange Club Center for Prevention of Child Abuse of the Space Coast

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MH2142 Issued in FL

Legal business name

EXCHANGE CLUB CENTER FOR PREVENTION OF CHILD ABUSE OF THE SPACE COAST

Doing business as

Yellow Umbrella

Practice address

4680 Lipscomb St NE
Suite 10a
Palm Bay, FL 32905-2984

Phone

(321) 723-2927

Fax

(321) 723-2928

NPI assigned

Nov 11, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Alethea M Kluver-Williams, LCSW

Title

Clinical Director

Phone

(321) 914-9971

Specialties & licenses 4

Addresses

Other names 1

• Yellow Umbrella Doing business as

Locations

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

{
    "created_epoch": "1320969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1114204625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4680 LIPSCOMB ST NE",
            "address_2": "SUITE 10A",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052984",
            "telephone_number": "321-723-2927",
            "fax_number": "321-723-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4680 LIPSCOMB ST NE",
            "address_2": "SUITE 10A",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052984",
            "telephone_number": "321-723-2927",
            "fax_number": "321-723-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCHANGE CLUB CENTER FOR PREVENTION OF CHILD ABUSE OF THE SPACE COAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-11",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "KLUVER-WILLIAMS",
        "authorized_official_first_name": "ALETHEA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "321-914-9971",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "FL",
            "license": "MH2142",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "MH2142",
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "FL",
            "license": "MH2142",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "MH2142",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yellow Umbrella",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Billy Jacob Estes, LMT
• Savannah Jane Estevez, RBT
• Farrah Estrada
• Luce Etienne
• Lisa Ann Eubank, MSW
• Monique Exume, FNP
• Eye Doctors Optical Outlets, PA (Eye Doctors Optical Outlets)
• Fidelis Ifeanyi Ezewike Jr.
• Amanda Ann Fadden, AUD
• Linda Fadden, OT

• Community/Behavioral Health Agency in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.