NPIMap

Organization Active NPI

Mahan Counseling, LLC

Doing business as Miracle City Counseling

  • Mental Health Counselor
  • Titusville, FL
National Provider Identifier
1285291633
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MAHAN COUNSELING, LLC
Doing business as
Miracle City Counseling
Practice address
5095 S Washington Ave Ste 102
Titusville, FL 32780-7333
Phone
(407) 917-6828
NPI assigned
May 21, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Authorized official

Name
Mrs. Kailey Rose Mahan, LMHCNPI 1588042089
Title
Counselor, Owner
Phone
(407) 917-6828

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 SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

5095 S Washington Ave Ste 102
Titusville, FL 32780-7333

Mailing address

4440 Osceola Rd
Titusville, FL 32780-6545

Other names 1

  • Miracle City Counseling Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL MiracleCityCounseling.com Direct

National Provider Directory

National Provider Directory

Locations

5095 S Washington Ave
Ste 102
Titusville, FL 32780
Phone (321) 252-8485

Practitioners & affiliated clinicians

Practitioners 5

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": "1558396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558396800000",
    "number": "1285291633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 OSCEOLA RD",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327806545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5095 S WASHINGTON AVE STE 102",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327807333",
            "telephone_number": "407-917-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHAN COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-05-21",
        "status": "A",
        "authorized_official_last_name": "MAHAN",
        "authorized_official_first_name": "KAILEY",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "COUNSELOR, OWNER",
        "authorized_official_telephone_number": "407-917-6828",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MiracleCityCounseling.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5095 S Washington Ave Ste 102",
            "city": "Titusville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327807333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Miracle City Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.