Fsba,Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH2814 Issued in FL

Legal business name

FSBA,INC

Practice address

19802 Old Bellamy Rd
Alachua, FL 32615-3867

Phone

(352) 278-1920

NPI assigned

Oct 6, 2016

Organization subpart

No

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

Authorized official

Name

Susan Deborah Cliett, LMHC

Title

Ceo

Phone

(352) 278-1920

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1427508100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19802 OLD BELLAMY RD",
            "city": "ALACHUA",
            "state": "FL",
            "postal_code": "326153867",
            "telephone_number": "352-278-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19802 OLD BELLAMY RD",
            "city": "ALACHUA",
            "state": "FL",
            "postal_code": "326153867",
            "telephone_number": "352-278-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FSBA,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "CLIETT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "DEBORAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "352-278-1920",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH2814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Lynn Damato Fox, APRN
• Jeffrey Fox
• Lenorea W Francis
• Amanda Beth Franco, BA
• Chelsea Frascoia, ATC, LAT
• Radharani Gaasbeek, RMFTI
• Jose Miguel Garces-Rivera, MD
• Ramacandra Gardner, LMT
• Janelle Annet Garner, APRN
• Stephanie Gerard

• Mental Health Counselor in Alachua, FL
• Providers in Alachua, 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 Oct 6, 2016; 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.