NPIMap

Organization Active NPI

Allegiance Clinical Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hollywood, FL
National Provider Identifier
1174967681
Registry record updated Apr 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
ALLEGIANCE CLINICAL COUNSELING LLC
Practice address
4835 Hollywood Blvd
2
Hollywood, FL 33021-6548
Phone
(954) 251-2796
Fax
(754) 400-9076
NPI assigned
Apr 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2013

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

Authorized official

Name
Vivian Mathis, LCSWNPI 1255682266
Title
Owner
Phone
(954) 251-2796

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4835 Hollywood Blvd
2
Hollywood, FL 33021-6548

Mailing address

4835 Hollywood Blvd
2
Hollywood, FL 33021-6548
Phone (954) 251-2796

National Provider Directory

National Provider Directory

Locations

4835 Hollywood Blvd
Ste 2
Hollywood, FL 33021
Phone (954) 251-2796

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1366934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366934400000",
    "number": "1174967681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 HOLLYWOOD BLVD",
            "address_2": "2",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216548",
            "telephone_number": "954-251-2796",
            "fax_number": "754-400-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 HOLLYWOOD BLVD",
            "address_2": "2",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216548",
            "telephone_number": "954-251-2796",
            "fax_number": "754-400-9076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGIANCE CLINICAL COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-26",
        "last_updated": "2013-04-26",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-251-2796",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.