NPIMap

Organization Active NPI

Supportive Therapy Empowering People, PLLC

  • Clinical Social Worker
  • Brandon, FL
National Provider Identifier
1396169819
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW8425 Issued in FL
Legal business name
SUPPORTIVE THERAPY EMPOWERING PEOPLE, PLLC
Practice address
220 W Brandon Blvd
Suite 203
Brandon, FL 33511-5104
Phone
(813) 892-6203
Fax
(813) 381-3909
NPI assigned
Feb 5, 2014
Last updated
Mar 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

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

Authorized official

Name
Reginald Vilmenay, LCSWNPI 1740455344
Title
LCSW
Phone
(813) 892-6203

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 Counselor 101YM0800X MH9398 FL
Clinical Social Worker 1041C0700X SW8425 FL Primary

Addresses

Primary practice location

220 W Brandon Blvd
Suite 203
Brandon, FL 33511-5104

Mailing address

220 W Brandon Blvd
Suite 203
Brandon, FL 33511-5104
Phone (813) 892-6203

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140227000588 FL Part B Supplier - Clinic/Group Practice 6305076910 Receives reassigned benefits from 9 practitioners
Practice locations: Brandon, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394409600000",
    "number": "1396169819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W BRANDON BLVD",
            "address_2": "SUITE 203",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115104",
            "telephone_number": "813-892-6203",
            "fax_number": "813-381-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W BRANDON BLVD",
            "address_2": "SUITE 203",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115104",
            "telephone_number": "813-892-6203",
            "fax_number": "813-381-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE THERAPY EMPOWERING PEOPLE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-05",
        "last_updated": "2014-03-10",
        "status": "A",
        "authorized_official_last_name": "VILMENAY",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "813-892-6203",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9398",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.