Masterpiece Counseling LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MASTERPIECE COUNSELING LLC

Practice address

2420 N Crystal Lake Dr Ste 200
Lakeland, FL 33801-6205

Phone

(863) 410-2095

NPI assigned

Apr 24, 2020

Organization subpart

No

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

Authorized official

Name

Michael Gruer Sullivan, LMHC, MCAPNPI 1063791747

Title

Owner/Operator

Phone

(863) 410-2095

Specialties & licenses 4

Addresses

Practitioners 1

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

• Michael Gruer Sullivan, LMHC, MCAP

  • Mental Health Counselor
  • Lakeland, FL
  • NPI 1063791747
  NPD Authorized official

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

{
    "created_epoch": "1587686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587686400000",
    "number": "1164042644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 GRANBY ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338016015",
            "telephone_number": "863-838-9437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 N CRYSTAL LAKE DR STE 200",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338016205",
            "telephone_number": "863-410-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASTERPIECE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-24",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "GRUER",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "863-410-2095",
        "authorized_official_credential": "LMHC, MCAP"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Sue Mason
• Tyshondra D Mason, PTA
• Mohammad Hamza Masood, MD
• Angel Omar Massanet Aponte, BEHAVIOR TECHNICIAN
• Joseph P Massaro, DO
• Herman Ricardo Matallana, DO
• Kristy Matasavage, DO
• Noreen Sitala Matautia
• Geoffrey John Mathai, PHARM D
• Ghardie Laura Mathelier

• Mental Health Counselor in Lakeland, FL
• Providers in Lakeland, 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 Apr 24, 2020; 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.