Emergency Services Provider Group, Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EMERGENCY SERVICES PROVIDER GROUP, INC

Practice address

1950 NE 6TH St Unit 2112
Pompano Beach, FL 33060-6541

Phone

(561) 508-8555

NPI assigned

Jun 13, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Malik Leigh

Title

Ceo

Phone

(561) 508-8555

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1134859325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2112",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330612112",
            "telephone_number": "405-921-6935",
            "fax_number": "888-323-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 NE 6TH ST UNIT 2112",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330606541",
            "telephone_number": "561-508-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY SERVICES PROVIDER GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "LEIGH",
        "authorized_official_first_name": "MALIK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-508-8555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "https://wlwell.com/api/",
            "affiliation": "Y",
            "endpointDescription": "S3 HIPAA Server",
            "affiliationName": "WL WELL, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "call data",
            "address_1": "2445 NE 14th Street Cswy",
            "city": "Pompano Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330628267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.