Active NPI
Venetta Brathwaite, MSW LCSWI
- Mental Health Counselor
- Altamonte Springs, FL
National Provider Identifier
1174864862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- ISW7630
- Practice address
- 801 Douglas Ave
Suite 208
Altamonte Springs, FL 32714-5206 - Phone
- (407) 830-6412
- NPI assigned
- Mar 6, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ISW7630 | FL | Primary |
Addresses
Primary practice location
801 Douglas Ave
Suite 208
Altamonte Springs, FL 32714-5206
Mailing address
9429 Nelson Park Circle
Apt 103
Orlando, FL 32817
Phone (412) 612-4555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW7630 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Support Services, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Altamonte Springs, FL
- NPI 1922145184
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362528000000",
"number": "1174864862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9429 NELSON PARK CIRCLE",
"address_2": "APT 103",
"city": "ORLANDO",
"state": "FL",
"postal_code": "32817",
"telephone_number": "412-612-4555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 DOUGLAS AVE",
"address_2": "SUITE 208",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327145206",
"telephone_number": "407-830-6412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRATHWAITE",
"first_name": "VENETTA",
"credential": "MSW LCSWI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-06",
"last_updated": "2013-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "ISW7630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Altamonte Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.