Introspective, LLC

Primary specialty

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

Legal business name

INTROSPECTIVE, LLC

Practice address

8400 N University Dr Ste 114
Tamarac, FL 33321-1700

Phone

(954) 774-2201

Fax

(954) 827-0988

NPI assigned

Aug 9, 2017

Organization subpart

No

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

Authorized official

Name

Sonny Etienne, LMHC

Title

Owner

Phone

(754) 281-0749

Specialties & licenses 2

Addresses

Locations

Networks

• HealthSun Health Plans Network

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573776000000",
    "number": "1194240291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 N UNIVERSITY DR STE 114",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333211700",
            "telephone_number": "954-774-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 N UNIVERSITY DR STE 114",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333211700",
            "telephone_number": "954-774-2201",
            "fax_number": "954-827-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTROSPECTIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-09",
        "last_updated": "2019-11-15",
        "status": "A",
        "authorized_official_last_name": "ETIENNE",
        "authorized_official_first_name": "SONNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "754-281-0749",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Tamarac, FL
• Providers in Tamarac, 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 Nov 15, 2019; 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.