NPIMap

Organization Active NPI

Fort Lauderdale Couples, Family and Individual Therapy, LLC

  • Mental Health Counselor
  • Wilton Manors, FL
National Provider Identifier
1235578808
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH11689 Issued in FL
Legal business name
FORT LAUDERDALE COUPLES, FAMILY AND INDIVIDUAL THERAPY, LLC
Practice address
1881 NE 26TH St
Suite 221
Wilton Manors, FL 33305-1416
Phone
(954) 789-9061
NPI assigned
Jun 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Authorized official

Name
Douglas B Nelson, LHMC
Title
Owner
Phone
(954) 789-9061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MH11689 FL Primary

Addresses

Primary practice location

1881 NE 26TH St
Suite 221
Wilton Manors, FL 33305-1416

Mailing address

1881 NE 26TH St
Suite 221
Wilton Manors, FL 33305-1416
Phone (954) 789-9061

National Provider Directory

National Provider Directory
Tax ID family
Fort Lauderdale Couples Family and Individual Therapy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445299200000",
    "number": "1235578808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 NE 26TH ST",
            "address_2": "SUITE 221",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051416",
            "telephone_number": "954-789-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 NE 26TH ST",
            "address_2": "SUITE 221",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051416",
            "telephone_number": "954-789-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT LAUDERDALE COUPLES, FAMILY AND INDIVIDUAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-17",
        "last_updated": "2015-10-20",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-789-9061",
        "authorized_official_credential": "LHMC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton Manors, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; 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.