NPIMap

Organization Active NPI

Eagle'S Wings Counseling Center, Inc.

  • Mental Health Counselor
  • Venice, FL
National Provider Identifier
1174857486
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
EAGLE'S WINGS COUNSELING CENTER, INC.
Practice address
405 Commercial CT Ste E
Venice, FL 34292-1653
Phone
(941) 375-4321
Fax
(941) 375-4096
NPI assigned
Sep 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Authorized official

Name
Dave Upton, M.A.
Title
Executive Director
Phone
(941) 375-4321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

405 Commercial CT Ste E
Venice, FL 34292-1653

Mailing address

405 Commercial CT Ste E
Venice, FL 34292-1653
Phone (941) 375-4321

National Provider Directory

National Provider Directory

Locations

405 Commercial Ct
Ste E
Venice, FL 34292
Phone (941) 375-4321

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364774400000",
    "number": "1174857486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 COMMERCIAL CT STE E",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342921653",
            "telephone_number": "941-375-4321",
            "fax_number": "941-375-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 COMMERCIAL CT STE E",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342921653",
            "telephone_number": "941-375-4321",
            "fax_number": "941-375-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE'S WINGS COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-21",
        "last_updated": "2013-04-01",
        "status": "A",
        "authorized_official_last_name": "UPTON",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "941-375-4321",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.