Organization Active NPI

Real Therapy Solutions, Inc

  • Mental Health Counselor
  • Port Charlotte, FL
National Provider Identifier
1184174286
Registry record updated Oct 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH10076 Issued in FL
Legal business name
REAL THERAPY SOLUTIONS, INC
Practice address
3028 Caring Way
Unit 1
Port Charlotte, FL 33952
Phone
(941) 276-7889
Fax
(941) 249-5039
NPI assigned
Oct 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2017

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

Authorized official

Name
Mr. Randall Crouch, LMHCNPI 1982930137
Title
Ceo
Phone
(941) 276-7889

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 CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MH10076 FL Primary

Addresses

Primary practice location

3028 Caring Way
Unit 1
Port Charlotte, FL 33952

Mailing address

3028 Caring Way
Unit 1
Port Charlotte, FL 33952
Phone (941) 276-7889

Other practice location 1

1620 Tamiami Trl
Suite 210
Port Charlotte, FL 33948-4015
Phone (941) 276-7889

Other identifiers 1

IdentifierTypeStateIssuer
004032500MedicaidFL

National Provider Directory

National Provider Directory

Locations

1620 Tamiami Trl
Ste 210
Port Charlotte, FL 33948
Phone (941) 276-7889

3028 Caring Way
Unit 1
Pt Charlotte, FL 33952
Phone (239) 277-7997

Practitioners & affiliated clinicians

Practitioners 1

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": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507248000000",
    "number": "1184174286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3028 CARING WAY",
            "address_2": "UNIT 1",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33952",
            "telephone_number": "941-276-7889",
            "fax_number": "941-249-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3028 CARING WAY",
            "address_2": "UNIT 1",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33952",
            "telephone_number": "941-276-7889",
            "fax_number": "941-249-5039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1620 Tamiami Trl",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "339484015",
            "country_code": "US",
            "telephone_number": "941-276-7889",
            "fax_number": "941-249-5039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REAL THERAPY SOLUTIONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2017-10-06",
        "status": "A",
        "authorized_official_last_name": "CROUCH",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "941-276-7889",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004032500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; 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.