NPIMap

Organization Active NPI

PPCC, Inc.

  • Mental Health Counselor
  • Crestview, FL
National Provider Identifier
1164747739
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH3244 Issued in FL
Legal business name
PPCC, INC.
Practice address
259 E Oakdale Ave
Crestview, FL 32539-3547
Phone
(850) 398-5255
Fax
(850) 689-8799
NPI assigned
Apr 7, 2010
Last updated
Mar 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Authorized official

Name
Ms. Susan M Page, LMHCNPI 1104979863
Title
President
Phone
(850) 682-1234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH5026 FL
Mental Health Counselor 101YM0800X MH3313 NU
Mental Health Counselor 101YM0800X MH3244 FL Primary
Psychologist 103T00000X PY7250 FL

Addresses

Primary practice location

259 E Oakdale Ave
Crestview, FL 32539-3547

Mailing address

259 E Oakdale Ave
Crestview, FL 32539-3547
Phone (850) 398-5255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100819000919 FL Part B Supplier - Clinic/Group Practice 3870627284 Receives reassigned benefits from 14 practitioners
Practice locations: Crestview, FL; Fort Walton Beach, FL

National Provider Directory

National Provider Directory

Locations

259 E Oakdale Ave
Crestview, FL 32539
Phone (850) 682-1234

295 E Oakdale Ave
Crestview, FL 32539

7 Vine Ave NE
Fort Walton Beach, FL 32548
Phone (850) 682-1234

7 Vine Ave NE
#N
Fort Walton Beach, FL 32548
Phone (850) 226-4098

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773705600000",
    "number": "1164747739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E OAKDALE AVE",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325393547",
            "telephone_number": "850-398-5255",
            "fax_number": "850-689-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E OAKDALE AVE",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325393547",
            "telephone_number": "850-398-5255",
            "fax_number": "850-689-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PPCC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-07",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-682-1234",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH5026",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": "MH3313",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH3244",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY7250",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; 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.