Space Coast Counseling, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SPACE COAST COUNSELING, LLC

Practice address

1197 Rockledge Blvd
Suite 1
Rockledge, FL 32955-2713

Phone

(321) 693-8618

NPI assigned

Dec 24, 2024

Organization subpart

No

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

Authorized official

Name

Kristen M Pena, MA, LMHC

Title

Owner-Licensed Mental Health Counse

Phone

(321) 693-8618

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1734998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734998400000",
    "number": "1407664279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1197 ROCKLEDGE BLVD",
            "address_2": "SUITE 1",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552713",
            "telephone_number": "321-693-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1197 ROCKLEDGE BLVD",
            "address_2": "SUITE 1",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552713",
            "telephone_number": "321-693-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-24",
        "last_updated": "2024-12-24",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER-LICENSED MENTAL HEALTH COUNSE",
        "authorized_official_telephone_number": "321-693-8618",
        "authorized_official_credential": "MA, LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Rockledge, FL
• Providers in Rockledge, 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 Dec 24, 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.