Organization Active NPI

Peace Therapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Myers, FL
National Provider Identifier
1366915944
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PEACE THERAPY
Practice address
10461 6 Mile Cypress Pkwy Ste 504
Fort Myers, FL 33966-6513
Phone
(941) 467-2980
NPI assigned
Jan 7, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Authorized official

Name
Jeffrey Douglas Lapham, LMHCNPI 1346618915
Title
Director
Phone
(941) 467-2980

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

10461 6 Mile Cypress Pkwy Ste 504
Fort Myers, FL 33966-6513

Mailing address

10461 6 Mile Cypress Pkwy Ste 504
Fort Myers, FL 33966-6513
Phone (941) 467-2980

Other identifiers 1

IdentifierTypeStateIssuer
116077800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240815000129 FL Part B Supplier - Clinic/Group Practice 2163960642 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

8140 College Pkwy
Ste 2023
Fort Myers, FL 33919

10461 6 Mile Cypress Pkwy
Ste 504
Fort Myers, FL 33966
Phone (239) 986-9662

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": "1546819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1366915944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10461 6 MILE CYPRESS PKWY STE 504",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339666513",
            "telephone_number": "941-467-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10461 6 MILE CYPRESS PKWY STE 504",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339666513",
            "telephone_number": "941-467-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-07",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "LAPHAM",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "941-467-2980",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116077800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.