Organization Active NPI

Supportive Engagement LLC

  • Mental Health Counselor
  • Davie, FL
National Provider Identifier
1255058293
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SUPPORTIVE ENGAGEMENT LLC
Practice address
7320 Griffin Rd Ste 223
Davie, FL 33314-4105
Phone
(954) 405-8415
NPI assigned
Oct 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Jeymarie Guerra, LMHCNPI 1487055729
Title
Owner / Manager
Phone
(954) 405-8415

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 MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

7320 Griffin Rd Ste 223
Davie, FL 33314-4105

Mailing address

7320 Griffin Rd Ste 223
Davie, FL 33314-4105
Phone (954) 405-8415

National Provider Directory

National Provider Directory

Locations

7320 Griffin Rd
Ste 223
Davie, FL 33314
Phone (561) 317-7832

Practitioners & affiliated clinicians

Practitioners 4

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": "1666224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1255058293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 GRIFFIN RD STE 223",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333144105",
            "telephone_number": "954-405-8415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7320 GRIFFIN RD STE 223",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333144105",
            "telephone_number": "954-405-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE ENGAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-20",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "GUERRA",
        "authorized_official_first_name": "JEYMARIE",
        "authorized_official_title_or_position": "OWNER / MANAGER",
        "authorized_official_telephone_number": "954-405-8415",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.