Individual provider Active NPI

Teresa Anne Pilacek, MA

  • Mental Health Counselor
  • Winter Park, FL
National Provider Identifier
1114457082
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
17243 Issued in FL
Practice address
2479 Aloma Ave
Winter Park, FL 32792-2541
Phone
(407) 657-6692
Fax
(407) 894-6010
NPI assigned
Jun 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH16130 FL
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 17243 FL Primary

Addresses

Primary practice location

2479 Aloma Ave
Winter Park, FL 32792-2541

Mailing address

2441 W Sr 426 Ste 1051
Oviedo, FL 32765-4516
Phone (321) 263-8763

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
17243FLMDMental Health Counselor
IMH16130FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114457082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 W SR 426 STE 1051",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327654516",
            "telephone_number": "321-263-8763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2479 ALOMA AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327922541",
            "telephone_number": "407-657-6692",
            "fax_number": "407-894-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILACEK",
        "first_name": "TERESA",
        "middle_name": "ANNE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH16130",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "17243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.