NPIMap

Organization Active NPI

Shardae Tripp Counseling, LLC

  • Mental Health Counselor
  • Port Saint Lucie, FL
National Provider Identifier
1134809239
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SHARDAE TRIPP COUNSELING, LLC
Practice address
5590 NW Pine Trail Cir
Port Saint Lucie, FL 34983-5349
Phone
(772) 418-7797
NPI assigned
Jul 24, 2023
Last updated
Jul 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Authorized official

Name
Shardae TrippNPI 1700310513
Title
Ceo
Phone
(772) 418-7797

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

5590 NW Pine Trail Cir
Port Saint Lucie, FL 34983-5349

Mailing address

5590 NW Pine Trail Cir
Port Saint Lucie, FL 34983-5349

National Provider Directory

National Provider Directory
Tax ID family
Shardae Tripp Counseling LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1134809239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5590 NW PINE TRAIL CIR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349835349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5590 NW PINE TRAIL CIR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349835349",
            "telephone_number": "772-418-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARDAE TRIPP COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-23",
        "status": "A",
        "authorized_official_last_name": "TRIPP",
        "authorized_official_first_name": "SHARDAE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "772-418-7797"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.