Upper Room Counseling Center, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH-4358 Issued in FL

Legal business name

UPPER ROOM COUNSELING CENTER, INC.

Practice address

3420 Hwy 27/441
Fruitland Park, FL 34731-4474

Phone

(352) 435-4631

Fax

(352) 435-4632

NPI assigned

Oct 7, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Jerry Franklin Phillips, L.M.H.C.NPI 1114103751

Title

Director of Counseling

Phone

(352) 435-4631

Specialties & licenses 7

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerry Franklin Phillips, LMHC

  • Mental Health Counselor
  • Melbourne, FL
  • NPI 1114103751
  NPD (past) Authorized official

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343692800000",
    "number": "1134439235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 HWY 441/27",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "347314474",
            "telephone_number": "352-435-4631",
            "fax_number": "352-435-4632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 HWY 27/441",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "347314474",
            "telephone_number": "352-435-4631",
            "fax_number": "352-435-4632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER ROOM COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-07",
        "last_updated": "2012-07-31",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "FRANKLIN",
        "authorized_official_title_or_position": "DIRECTOR OF COUNSELING",
        "authorized_official_telephone_number": "352-435-4631",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.M.H.C."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH-4358",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "MH-4358",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH-4358",
            "primary": true
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": "FL",
            "license": "MH-4358",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH-4358",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": "FL",
            "license": "MH-4358",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MH-4358",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber L. Trujillo
• Alexis Trunzo, LCSW
• Trusted Home Care Services Nurse Registry
• David Turner, D.M.D.
• Matthew Joseph Uhrik, D.C., M.S., M.S.
• Shanti Vega
• Marilyn Velez-Coriano
• Michael Tan Villamor
• Jennifer Voehringer, LMT
• Marissa Ann Walters, PMD

• Mental Health Counselor in Fruitland Park, FL
• Providers in Fruitland Park, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; 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.