TMS of Emerald Coast LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

TMS OF EMERALD COAST LLC

Practice address

403 Hollywood Blvd NW Ste 103a
Fort Walton Beach, FL 32548-4531

Phone

(801) 245-0577

NPI assigned

Feb 2, 2024

Organization subpart

No

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

Authorized official

Name

Mindy McClellan

Title

Owner

Phone

(801) 245-0577

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1356104269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 HOLLYWOOD BLVD NW STE 103A",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484531",
            "telephone_number": "801-245-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 HOLLYWOOD BLVD NW STE 103A",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484531",
            "telephone_number": "801-245-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TMS OF EMERALD COAST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "MCCLELLAN",
        "authorized_official_first_name": "MINDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-245-0577"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.