Clearwater Counseling Center LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

SW 3074 Issued in FL

Legal business name

CLEARWATER COUNSELING CENTER LLC

Practice address

25400 US Highway 19 N
Suite 172
Clearwater, FL 33763-2149

Phone

(727) 797-7211

NPI assigned

Apr 5, 2016

Last updated

Apr 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Mary Ann Lane, BCD, LCSW

Title

Sole MBR

Phone

(727) 417-4491

Specialties & licenses 1

Addresses

Locations

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.

• Caroline H. Fenderson, M.A., P.A.

  • Mental Health Counselor
  • Clearwater, FL
  • NPI 1255405361
  NPD (past)

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1184088262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 HOMESTEAD CT",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337591619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25400 US HIGHWAY 19 N",
            "address_2": "SUITE 172",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337632149",
            "telephone_number": "727-797-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "727-417-4491",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BCD, LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "FL",
            "license": "SW 3074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clearwater Aesthetics and Plastic Surgery
• Clearwater Ambulatory Surgical Centers Inc (Clearwater Endoscopy Center)
• Clearwater Beach Spa, Inc.
• Clearwater Cardiovascular and Interventional Consultants MD PA
• Clearwater Chiropractic Center LLC
• Clearwater Dental Associates PL
• Clearwater Dental Care PLLC
• Clearwater Dentistry
• Clearwater Dermatologic & Aesthetic Institute PA
• Clearwater Dermatology, P.a.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.