NPIMap

Organization Active NPI

Progressive Counseling Centers Inc

Doing business as Brevard Outpatient Alternative Treatment

  • Addiction (Substance Use Disorder) Counselor
  • Satellite Beach, FL
National Provider Identifier
1275692204
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
0705AD916901 Issued in FL
Legal business name
PROGRESSIVE COUNSELING CENTERS INC
Doing business as
Brevard Outpatient Alternative Treatment
Practice address
1127 S Patrick Dr
Suite 24
Satellite Beach, FL 32937-3939
Phone
(321) 773-1111
Fax
(321) 773-1692
NPI assigned
Dec 6, 2006
Last updated
Jun 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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

Authorized official

Name
Mr. John W Holdsworth, M.S.
Title
Executive Director
Phone
(321) 773-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0705AD916901 FL Primary

Addresses

Primary practice location

1127 S Patrick Dr
Suite 24
Satellite Beach, FL 32937-3939

Mailing address

1127 S Patrick Dr
Suite 24
Satellite Beach, FL 32937-3939
Phone (321) 773-1111

Other names 1

  • Brevard Outpatient Alternative Treatment Doing business as

National Provider Directory

National Provider Directory

Locations

1127 South Patrick Dr
Ste 24
Satellite Beach, FL 32937
Phone (321) 773-1111

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244592000000",
    "number": "1275692204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 S PATRICK DR",
            "address_2": "SUITE 24",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329373939",
            "telephone_number": "321-773-1111",
            "fax_number": "321-773-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 S PATRICK DR",
            "address_2": "SUITE 24",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329373939",
            "telephone_number": "321-773-1111",
            "fax_number": "321-773-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE COUNSELING CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2009-06-10",
        "status": "A",
        "authorized_official_last_name": "HOLDSWORTH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "321-773-1111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "0705AD916901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brevard Outpatient Alternative Treatment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Satellite Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; 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.