NPIMap

Organization Active NPI

Healing Educational Alternatives for Deserving Students

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1437550266
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
05 Issued in FL
Legal business name
HEALING EDUCATIONAL ALTERNATIVES FOR DESERVING STUDENTS
Practice address
50 N Laura St
Suite 2500
Jacksonville, FL 32202-3664
Phone
(813) 754-5555
Fax
(813) 754-5552
NPI assigned
Sep 11, 2014
Last updated
Sep 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Authorized official

Name
Edward A Waller, M.EDNPI 1811387178
Title
Coo
Phone
(813) 754-5555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 05 FL Primary

Addresses

Primary practice location

50 N Laura St
Suite 2500
Jacksonville, FL 32202-3664

Mailing address

1001 E Baker St
Suite 202
Plant City, FL 33563-3700
Phone (813) 754-5555

Other identifiers 6

IdentifierTypeStateIssuer
007813200MedicaidFL
1326311085OtherFLNPI TAMPA LOCATION
006323200MedicaidFL
007862400MedicaidFL
1073871208OtherFLNPI- FORT MYERS LOCATION
1053658153OtherFLNPI- ORLANDO LOCATION

Other names 1

  • HEADS Other name

National Provider Directory

National Provider Directory
Tax ID family
Healing Educational Alternatives for Deserving Students LLC Heads19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

1001 E Baker St
Ste 202
Plant City, FL 33563
Phone (813) 610-0095

Practitioners & affiliated clinicians

Practitioners 6

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": "1410393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1437550266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E BAKER ST",
            "address_2": "SUITE 202",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335633700",
            "telephone_number": "813-754-5555",
            "fax_number": "813-754-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N LAURA ST",
            "address_2": "SUITE 2500",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322023664",
            "telephone_number": "813-754-5555",
            "fax_number": "813-754-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING EDUCATIONAL ALTERNATIVES FOR DESERVING STUDENTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "813-754-5555",
        "authorized_official_credential": "M.ED"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "05",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007813200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TAMPA LOCATION",
            "identifier": "1326311085",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006323200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007862400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI- FORT MYERS LOCATION",
            "identifier": "1073871208",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI- ORLANDO LOCATION",
            "identifier": "1053658153",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEADS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.