The Door Christian Counseling, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH6655 Issued in FL

Legal business name

THE DOOR CHRISTIAN COUNSELING, LLC

Practice address

1000 N Banana River Dr
Merritt Island, FL 32952

Phone

(321) 749-3589

NPI assigned

Apr 11, 2015

Organization subpart

No

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

Authorized official

Name

Mr. William Raeford Fletcher Jr.

Title

Manager

Phone

(321) 543-3898

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pamela Krake Fletcher, MS,LMHC

  • Mental Health Counselor
  • Merritt Island, FL
  • NPI 1790847127
  NPD (past)

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

{
    "created_epoch": "1428710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528156800000",
    "number": "1376939835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 S COURTENAY PKWY # 582",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524843",
            "telephone_number": "321-749-3589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N BANANA RIVER DR",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "32952",
            "telephone_number": "321-749-3589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DOOR CHRISTIAN COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-11",
        "last_updated": "2018-06-05",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "RAEFORD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "321-543-3898",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH6655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.