Sea Change Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SEA CHANGE COUNSELING LLC

Practice address

110 Sanchez Ave
Edgewater, FL 32132-1638

Phone

(386) 481-4782

NPI assigned

Mar 3, 2023

Organization subpart

No

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

Authorized official

Name

Trisha PetersonNPI 1023561883

Title

Clinical Social Worker

Phone

(386) 481-4782

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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.

• Trisha S Peterson, RSWI

  • Clinical Social Worker
  • Edgewater, FL
  • NPI 1023561883
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677801600000",
    "number": "1144920711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SANCHEZ AVE",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321321638",
            "telephone_number": "386-481-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SANCHEZ AVE",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321321638",
            "telephone_number": "386-481-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA CHANGE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "TRISHA",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "386-481-4782"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Schierlinger Podiatry Center
• Kurt A Schierlinger, D.P.M.
• Matthew Schroeder
• Kyra Schweizer
• Amber Nichole Scott, D.C.
• Kami Teresa Seifert, FNP-C
• Serenity Springs LLC
• Antoinise Servius
• Sharon L Shelton, DO
• Candy Shields

• Clinical Social Worker in Edgewater, FL
• Providers in Edgewater, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.