NPIMap

Organization Active NPI

Beachside Recovery Interventions & Consulting LLC

  • Psychologist
  • Satellite Beach, FL
National Provider Identifier
1427725126
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
BEACHSIDE RECOVERY INTERVENTIONS & CONSULTING LLC
Practice address
1640 Highway A1A Ste C
Satellite Beach, FL 32937-5451
Phone
(321) 978-4041
NPI assigned
Aug 30, 2021
Last updated
Aug 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Authorized official

Name
Drew David Breznitsky
Title
Owner
Phone
(321) 978-4041

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Psychologist 103T00000X Primary

Addresses

Primary practice location

1640 Highway A1A Ste C
Satellite Beach, FL 32937-5451

Mailing address

1640 Highway A1A Ste C
Satellite Beach, FL 32937-5451
Phone (321) 978-4041

National Provider Directory

National Provider Directory

Locations

1640 Highway A1A
Ste C
Satellite Beach, FL 32937
Phone (321) 978-4041

Practitioners & affiliated clinicians

Practitioners 2

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": "1630281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1427725126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 HIGHWAY A1A STE C",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329375451",
            "telephone_number": "321-978-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 HIGHWAY A1A STE C",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329375451",
            "telephone_number": "321-978-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHSIDE RECOVERY INTERVENTIONS & CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "BREZNITSKY",
        "authorized_official_first_name": "DREW DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-978-4041"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Satellite Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.