Center of Agape Christian Counseling, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW1370 Issued in FL

Legal business name

CENTER OF AGAPE CHRISTIAN COUNSELING, LLC

Practice address

4907 Van Dyke Rd
Lutz, FL 33558-4813

Phone

(813) 962-1018

Fax

(813) 265-3966

NPI assigned

Aug 25, 2015

Organization subpart

No

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

Authorized official

Name

Mildred W Phillips, LCSWNPI 1053429852

Title

Owner

Phone

(813) 962-1018

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Mildred W Phillips, LCSW

  • Clinical Social Worker
  • Lutz, FL
  • NPI 1053429852
  Medicare reassignment Authorized official
• Helen Y Choi, MD

  • Psychiatry Physician
  • Lutz, FL
  • NPI 1093042293
  NPD

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440460800000",
    "number": "1184091183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4907 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584813",
            "telephone_number": "813-962-1018",
            "fax_number": "813-265-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4907 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584813",
            "telephone_number": "813-962-1018",
            "fax_number": "813-265-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER OF AGAPE CHRISTIAN COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-25",
        "last_updated": "2015-08-25",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "MILDRED",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-962-1018",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW1370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002809400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "BL767A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Michael Cater
• Dawn Cave
• Stephany Cedano
• Center for Comprehensive Services, Inc.
• Center for Comprehensive Services, Inc.
• Cep America
• Pamela Cepeda
• Lindsay Cerant, RBT
• Christopher Certain
• CG1 Chiropractic Clinic, Inc.

• Clinical Social Worker in Lutz, FL
• Providers in Lutz, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.