Bayside Recovery and Wellness Center LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BAYSIDE RECOVERY AND WELLNESS CENTER LLC

Practice address

1501 Robert J Conlan Blvd NE Ste 7
Palm Bay, FL 32905-3559

Phone

(321) 372-6897

Fax

(321) 372-6896

NPI assigned

Aug 16, 2019

Organization subpart

No

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

Authorized official

Name

Morgan O'Shaughnessy, LMHCNPI 1407479876

Title

Ceo/Clincial Director

Phone

(321) 372-6897

Specialties & licenses 5

Addresses

Other names 1

• BAYSIDE RECOERY AND WELLNESS CENTER LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

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

• Morgan O'Shaughnessy

  • Mental Health Counselor
  • Melbourne, FL
  • NPI 1407479876
  Medicare reassignment NPD Authorized official
• Fritz Jean-Noel, MD

  • Psychiatry Physician
  • Boynton Beach, FL
  • NPI 1881891943
  Medicare reassignment NPD
• Kerstin Welch, LCSW

  • Clinical Social Worker
  • Indialantic, FL
  • NPI 1174283097
  Medicare reassignment NPD
• Stanton Tucker Cooper, DC, DACAN

  • Neurology Chiropractor
  • Palm Bay, FL
  • NPI 1568542546
  NPD
• Aolani Mayo, LMHC

  • Mental Health Counselor
  • Palm Bay, FL
  • NPI 1164259529
  NPD

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1134775976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 ROBERT J CONLAN BLVD NE STE 7",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329053559",
            "telephone_number": "321-372-6897",
            "fax_number": "321-372-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 ROBERT J CONLAN BLVD NE STE 7",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329053559",
            "telephone_number": "321-372-6897",
            "fax_number": "321-372-6896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE RECOVERY AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-16",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "O'SHAUGHNESSY",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "CEO/CLINCIAL DIRECTOR",
        "authorized_official_telephone_number": "321-372-6897",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BAYSIDE RECOERY AND WELLNESS CENTER LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BAYSIDE RECOERY AND WELLNESS CENTER LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracy Kilian Battle, PTA
• H Robert Bauman II, D.V.M.
• Bayside Dental Care LLC
• Bayside Family Counseling LLC
• Bayside Lakes Pharmacy LLC
• Alexis Beaufort
• Stephanie Beauregard, P.T.
• Beautifully Graced LLC
• Cheryl Denise Bebey, LCSW CEAP
• Carol Bechtel, RPH

• 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 Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.