NPIMap

Organization Active NPI

Catalyst for Change Psychiatric & Counseling Services

  • Mental Health Counselor
  • Port Saint Lucie, FL
National Provider Identifier
1194335216
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CATALYST FOR CHANGE PSYCHIATRIC & COUNSELING SERVICES
Practice address
1814 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5545
Phone
(772) 208-7834
Fax
(949) 577-4617
NPI assigned
Aug 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Authorized official

Name
Chasity Shanell Chandler, LMHC
Title
Owner
Phone
(772) 208-7834

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1814 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5545

Mailing address

1814 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5545
Phone (772) 208-7834

Other practice location 1

833 22nd St S Ste S
St Petersburg, FL 33712-2250
Phone (772) 208-7834

Other practice location 2

2440 SE Federal Hwy Ste Q
Stuart, FL 34994-4531
Phone (772) 208-7834

Other practice location 3

333 17th St Ste F
Vero Beach, FL 32960-5636
Phone (772) 208-7834

National Provider Directory

National Provider Directory

Locations

333 17th St
Ste F
Vero Beach, FL 32960
Phone (203) 494-6008

Practitioners & affiliated clinicians

Practitioners 2

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": "1596499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596499200000",
    "number": "1194335216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 SE PORT ST LUCIE BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525545",
            "telephone_number": "772-208-7834",
            "fax_number": "949-577-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 SE PORT ST LUCIE BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525545",
            "telephone_number": "772-208-7834",
            "fax_number": "949-577-4617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 22nd St S Ste S",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337122250",
            "country_code": "US",
            "telephone_number": "772-208-7834",
            "fax_number": "949-577-4617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2440 SE Federal Hwy Ste Q",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349944531",
            "country_code": "US",
            "telephone_number": "772-208-7834",
            "fax_number": "949-577-4617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 17th St Ste F",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329605636",
            "country_code": "US",
            "telephone_number": "772-208-7834",
            "fax_number": "949-577-4617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CATALYST FOR CHANGE PSYCHIATRIC & COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A",
        "authorized_official_last_name": "CHANDLER",
        "authorized_official_first_name": "CHASITY",
        "authorized_official_middle_name": "SHANELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-208-7834",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.