NPIMap

Organization Active NPI

Community Victory Family Services Inc

  • Mental Health Counselor
  • Tampa, FL
National Provider Identifier
1346735008
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH13166 Issued in FL
Legal business name
COMMUNITY VICTORY FAMILY SERVICES INC
Practice address
8905 Regents Park Dr Ste 230
Tampa, FL 33647-3081
Phone
(800) 715-3606
NPI assigned
Jun 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Authorized official

Name
Mr. Taiwan Simmons
Title
Director of Operations
Phone
(800) 715-3606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MH13166 FL Primary

Addresses

Primary practice location

8905 Regents Park Dr Ste 230
Tampa, FL 33647-3081

Mailing address

PO Box 7731
Wesley Chapel, FL 33545-0113
Phone (800) 715-3606

Other practice location 1

5400 School Rd
New Port Richey, FL 34652-4318
Phone (800) 715-3606 ext. 103

Other identifiers 1

IdentifierTypeStateIssuer
014618400MedicaidFL

National Provider Directory

National Provider Directory

Locations

5400 School Rd
New Port Richey, FL 34652
Phone (727) 842-3322

Practitioners & affiliated clinicians

Practitioners 1

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": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529971200000",
    "number": "1346735008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7731",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335450113",
            "telephone_number": "800-715-3606",
            "fax_number": "813-906-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8905 REGENTS PARK DR STE 230",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473081",
            "telephone_number": "800-715-3606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5400 School Rd",
            "address_purpose": "LOCATION",
            "city": "New Port Richey",
            "state": "FL",
            "postal_code": "346524318",
            "country_code": "US",
            "telephone_number": "800-715-3606 x103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY VICTORY FAMILY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "TAIWAN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "800-715-3606",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014618400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.